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MONDAY MADNESS

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by

Michael Cerasaro

on 12 June 2017

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Transcript of MONDAY MADNESS

Dx:
CT: localized bowel wall thickening (>4 mm), inc soft tissue density/inflammation or fat stranding, and the presence of colonic diverticula
Mgmt:
ADMIT IF:
Complicated: perforation, abscess, obstruction, or fistulization.
Uncomplicated but a/w Sepsis, mmunosuppression,
•High fever (>102.5°F/39°C)
•Significant leukocytosis
•Severe abdominal pain or diffuse peritonitis
•Advanced age
•Significant comorbidities
•Intolerance of oral intake
•Noncompliance/unreliability for return visits/lack of support system
Diverticulosis!
Osis vs. Itis
Risk:
Low Fiber, Lots of red meat/fat,
seeds/nuts?
obesity,
exercise?


Osis:
weak points at vasa recta penetrae
Itis:
micro-perforations as a result of inc. pressure from fecaliths
MONDAY MADNESS
MAC
When to surgerize:
1) Frank Perf
2) Failure of medical management
3) Obstruction?
4) Peridiverticular abscess
5) Fistula
6) Sometimes chronic smoldering
7) Sometimes High risk (Immunocomprimised/prior complicated)
Full transcript