Diverticulosis - Revision history

Ostermayer: Prepared the page for translation

2026-01-04T22:49:05Z

Prepared the page for translation

← Older revision		Revision as of 22:49, 4 January 2026
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			<languages/>
			<translate>

	==Background==		==Background==

	[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]		[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]
	*Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation		*Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation
	**If microperfs become infected/inflamed, can lead to [[diverticulitis]]		**If microperfs become infected/inflamed, can lead to [[Special:MyLanguage/diverticulitis\|diverticulitis]]
	*Prevalence of diverticulosis 30% by age 60, >70% by age 85		*Prevalence of diverticulosis 30% by age 60, >70% by age 85
	*70% of patients with diverticulosis remain asymptomatic		*70% of patients with diverticulosis remain asymptomatic
	*Diverticular disease is almost exclusively left-sided colon (USA) or right-sided (Asia)		*Diverticular disease is almost exclusively left-sided colon (USA) or right-sided (Asia)


	==Clinical Features==		==Clinical Features==

	*Typically asymptomatic OR		*Typically asymptomatic OR
	*[[Lower GI bleeding]], painless		*[[Special:MyLanguage/Lower GI bleeding\|Lower GI bleeding]], painless


	==Differential Diagnosis==		==Differential Diagnosis==

			</translate>
	{{Lower GI bleeding DDX}}		{{Lower GI bleeding DDX}}
			<translate>



	==Evaluation==		==Evaluation==

	*CBC		*CBC
	*Chemistries		*Chemistries
	**BUN may be elevated if bleeding occurs from site high in GI tract		**BUN may be elevated if bleeding occurs from site high in GI tract
	*Coags		*Coags
	*[[LFTs]]		*[[Special:MyLanguage/LFTs\|LFTs]]
	*Type and screen		*Type and screen
	*Fibrinogen		*Fibrinogen
	*[[ECG]] (if concern for silent ischemia in patients likely to have CAD)		*[[Special:MyLanguage/ECG\|ECG]] (if concern for silent ischemia in patients likely to have CAD)
	*CTA		*CTA
	**Requires brisk bleeding rate (0.5 cc/min) for detection{{Citation needed\|reason=Reliable source needed\|date=May 2016}}		**Requires brisk bleeding rate (0.5 cc/min) for detection{{Citation needed\|reason=Reliable source needed\|date=May 2016}}
	*Tagged red blood cell scan		*Tagged red blood cell scan


	==Management==		==Management==

	*Categorize as stable versus unstable using shock index (HR/SBP), SI <1 stable, >1 unstable or suspect active bleeding		*Categorize as stable versus unstable using shock index (HR/SBP), SI <1 stable, >1 unstable or suspect active bleeding
	*Unstable patients resuscitate, CT angiogram, if CTA does not identify source of bleeding, upper endoscopy if hemodynamic instability <ref> Oakland K, Chadwick G, East JE, et al. Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology. Gut 2019;67:776-789. </ref>		*Unstable patients resuscitate, CT angiogram, if CTA does not identify source of bleeding, upper endoscopy if hemodynamic instability <ref> Oakland K, Chadwick G, East JE, et al. Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology. Gut 2019;67:776-789. </ref>
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	**Oakland score		**Oakland score
	**Glasgow-Blatchford score		**Glasgow-Blatchford score
	*[[IVF]]		*[[Special:MyLanguage/IVF\|IVF]]
	*Consider transfusing [[pRBCs]]/[[platelets]] for unstable patients or with very low hemoglobin (<7). with cardiovascular disease use trigger of 8 and target of 10 hemoglobin.		*Consider transfusing [[Special:MyLanguage/pRBCs\|pRBCs]]/[[Special:MyLanguage/platelets\|platelets]] for unstable patients or with very low hemoglobin (<7). with cardiovascular disease use trigger of 8 and target of 10 hemoglobin.
	*Consider NGT - high possibility for surgery to request		*Consider NGT - high possibility for surgery to request
	*Emergent sigmoidoscopy/colonoscopy (next 24 hours)		*Emergent sigmoidoscopy/colonoscopy (next 24 hours)
	*Surgery if endoscopy fails or not available		*Surgery if endoscopy fails or not available


	===Major Bleed and Supratherapeutic INR===		===Major Bleed and Supratherapeutic INR===
	*[[Coagulopathy (main)\|Correct coagulopathy]]
	**[[Vitamin K]] 10mg IV (best bioavailability in critical patient)		*[[Special:MyLanguage/Coagulopathy (main)\|Correct coagulopathy]]
	**[[PCC]] or [[FFP]]		**[[Special:MyLanguage/Vitamin K\|Vitamin K]] 10mg IV (best bioavailability in critical patient)
			**[[Special:MyLanguage/PCC\|PCC]] or [[Special:MyLanguage/FFP\|FFP]]



	==Disposition==		==Disposition==

	*Depends on severity of bleeding		*Depends on severity of bleeding


	==See Also==		==See Also==
	*[[Lower GI bleeding]]
	*[[Diverticulitis]]		*[[Special:MyLanguage/Lower GI bleeding\|Lower GI bleeding]]
			*[[Special:MyLanguage/Diverticulitis\|Diverticulitis]]


	==External Links==		==External Links==
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	==References==		==References==

	<references/>		<references/>
	[[Category:GI]]		[[Category:GI]]
			</translate>

Rossdonaldson1: /* Background */

2025-09-24T21:05:07Z

Background

← Older revision		Revision as of 21:05, 24 September 2025
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	==Background==		==Background==
			[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]
	*Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation		*Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation
	**If microperfs become infected/inflamed, can lead to [[diverticulitis]]		**If microperfs become infected/inflamed, can lead to [[diverticulitis]]

ClaireLewis: /* Evaluation */

2019-09-29T20:23:13Z

Evaluation

← Older revision		Revision as of 20:23, 29 September 2019
Line 19:		Line 19:
	**BUN may be elevated if bleeding occurs from site high in GI tract		**BUN may be elevated if bleeding occurs from site high in GI tract
	*Coags		*Coags
	*LFTs		*[[LFTs]]
	*Type and screen		*Type and screen
	*Fibrinogen		*Fibrinogen

ClaireLewis: /* Background */

2019-08-26T02:31:32Z

Background

← Older revision		Revision as of 02:31, 26 August 2019
Line 1:		Line 1:
	==Background==		==Background==
	*Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation		*Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation
			**If microperfs become infected/inflamed, can lead to [[diverticulitis]]
	*Prevalence of diverticulosis 30% by age 60, >70% by age 85		*Prevalence of diverticulosis 30% by age 60, >70% by age 85
	*70% of patients with diverticulosis remain asymptomatic		*70% of patients with diverticulosis remain asymptomatic

ClaireLewis: Created page with "==Background== Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation Prevalence of diverticulosi..."

2019-08-26T02:30:13Z

Created page with "==Background== *Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation *Prevalence of diverticulosi..."

New page

==Background==
*Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation
*Prevalence of diverticulosis 30% by age 60, >70% by age 85
*70% of patients with diverticulosis remain asymptomatic
*Diverticular disease is almost exclusively left-sided colon (USA) or right-sided (Asia)

==Clinical Features==
*Typically asymptomatic OR
*[[Lower GI bleeding]], painless

==Differential Diagnosis==
{{Lower GI bleeding DDX}}

==Evaluation==
*CBC
*Chemistries
**BUN may be elevated if bleeding occurs from site high in GI tract
*Coags
*LFTs
*Type and screen
*Fibrinogen
*[[ECG]] (if concern for silent ischemia in patients likely to have CAD)
*CTA
**Requires brisk bleeding rate (0.5 cc/min) for detection{{Citation needed|reason=Reliable source needed|date=May 2016}}
*Tagged red blood cell scan

==Management==
*Categorize as stable versus unstable using shock index (HR/SBP), SI <1 stable, >1 unstable or suspect active bleeding
*Unstable patients resuscitate, CT angiogram, if CTA does not identify source of bleeding, upper endoscopy if hemodynamic instability <ref> Oakland K, Chadwick G, East JE, et al. Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology. Gut 2019;67:776-789. </ref>
*Stable calculate risk score
**Oakland score
**Glasgow-Blatchford score
*[[IVF]]
*Consider transfusing [[pRBCs]]/[[platelets]] for unstable patients or with very low hemoglobin (<7). with cardiovascular disease use trigger of 8 and target of 10 hemoglobin.
*Consider NGT - high possibility for surgery to request
*Emergent sigmoidoscopy/colonoscopy (next 24 hours)
*Surgery if endoscopy fails or not available

===Major Bleed and Supratherapeutic INR===
*[[Coagulopathy (main)|Correct coagulopathy]]
**[[Vitamin K]] 10mg IV (best bioavailability in critical patient)
**[[PCC]] or [[FFP]]

==Disposition==
*Depends on severity of bleeding

==See Also==
*[[Lower GI bleeding]]
*[[Diverticulitis]]

==External Links==

==References==
<references/>
[[Category:GI]]

Diverticulosis - Revision history

Ostermayer: Prepared the page for translation

Rossdonaldson1: /* Background */

ClaireLewis: /* Evaluation */

ClaireLewis: /* Background */

ClaireLewis: Created page with "==Background== *Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation *Prevalence of diverticulosi..."

ClaireLewis: Created page with "==Background== Outpouchings in colonic wall due to erosion of diverticular wall by inspissated fecal material, which can lead to microperforation Prevalence of diverticulosi..."