Discussion
Diverticulitis is a common clinical problem and the complications represent one of the commonest surgical emergencies with a high and increasing prevalence in Western Societies.[ , ] An estimated 10-25% of the population younger than 60 years of age show evidence of colonic diverticula on colonoscopy, rising to 60% of those over 60 years.[ , , ] Although only 5% of patients with diverticulosis will develop acute diverticulitis, around 25% of patients will experience symptoms.[ ] Younger males are known to suffer more severe complications from diverticular disease as the case we presented.[ ] The majority of episodes are treated as outpatients with antibiotics; however it is reported that acute diverticulitis and its complications are responsible for 50,000 emergency hospital admissions per year in the UK with mortality of around 5%.[ ]
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Laparoscopic approach results in a shorter length of stay, fewer complications, and lower in-hospital mortality compared to open colectomy.( ) Emergency colectomy is associated with significant morbidity, such as pneumonia (25%), respiratory failure (15%), myocardial infarction (12%) and increased mortality in older persons.[ ] Furthermore a systematic review concluded that resection with primary anastomosis in selected patients is equally safe procedure to Hartmann’s approach.[
It is believed that aging has something to do with compromising the muscle tone of the colonic wall; people aged 50 and over are most at risk for diverticulosis and diverticulitis. It is believed that high fat diets and obesity also play a role in developing diverticular disease.
Postoperative nursing care after a laparoscopic cholecystectomy includes monitoring for complications such as bleeding, making the patient comfortable, and preparing the patient for discharge. Assessment findings for poor wound healing include redness, tenderness, swelling, purulent drainage, pain, and fever. Monitoring white blood cell count is a way to see if there is a presence of a bacterial infection. Maintaining good fluid intake and nutrition promotes fast and good wound healing. The carbon dioxide can irritate the phrenic nerve
DS is a 57-year-old white female whit a history of diverticulitis who presents to the clinic for an evaluation of abdominal pain. She stated that she began experiencing left lower quadrant pain last night that worsened through the night and into this morning. The pain is described as dull, occasionally cramping, rated 7/10 in severity. The patient also stated that this pain is similar to previous episodes of diverticulitis. The patient stated that she took Gas-X this morning with little relief. She was able to move her bowels yesterday and this morning, both reportedly normal. The patient denied any fever, chills, chest pain, shortness of breath, nausea, vomiting, diarrhea, melena, hematochezia, or any other symptoms. At this time, there were
The inflammation in diverticulitis is believed to be the result of fecal material that gets trapped in a diverticulum. The resulting fecal stone, or fecalith, causes pressure and necrosis of the diverticulum. The inflammation progresses and perforates into the mucosa of the colon. A small perforation is easily treated with antibiotics. A large perforation may wall off and create an abscess which can erode into nearby structures such as the small bowel or bladder, anterior abdominal wall, and fecal peritonitis can occur. (textbook)
Pathophysiology: Diverticulitis, is characterized by inflamed diverticuli and increased luminal pressures that cause erosion of the bowel wall and thus microscopic or macroscopic perforation into the peritoneum. A localized abscess develops when the
Colonoscopy through ascending colon and biopsy. As well extensive diverticular disease of the left colon.
"Diverticulitis is a condition in which diverticuli in the colon rupture. The rupture results in infection in the tissues that surround the colon” (MedicineNet, 2010, para.1). Or at least that’s what MedicineNet.com states that it is. Sometimes what we find on the Internet isn’t as reliable as what we may think. Doing research and finding correct and reliable information is very important in the nursing practice. There is so much information available at our fingertips, but finding accurate information is sometimes a challenge and can be detrimental to patient care if the information found is inaccurate. The purpose of this assignment is to evaluate the validity of three health websites.
HISTORY- EPIDEMIOLOGY: Diverticulitis is an intestinal inflammation occurring as a complication to the disorder of diverticulosis. The global epidemiology is associated with the western culture diet, being far more common in industrialized countries like the United States, Canada, Australia and the United Kingdom, and much less prevalent in Asia and Africa. These two conditions were rare in the 18th century and appear to be linked to the reduction of fiber in flour due to the development of roller mills that replaced grist mills in the late 1800’s. Roller mills were a more efficient method of refining wheat into flour; however this resulted in the destroying or removal of most of the fiber from the grain. This
Thank you for your feedback. In regards to Urethral diverticulum, a research article stated urethral diverticulum is a condition whereby there is an outpouching tube next to the urethra (Pradhan, Ranjan, & Kapoor, 2012). This reason for the outpouching is because the urethra which is a tube repeatedly get filled up with urine during urination causing a burning or discomfort sensation. It also cause inflammation of the epithelial mucosa, a process whereby there is a thinned circumferential diverticular wall composed of fibromuscular tissue (Pradhan et al., 2012). This infection is mostly common in females between ages 30 and 70. The frequency of urethral diverticulum is unknown presently due to many missed or misdiagnosis infection accuracy
The surgeon follows the same procedure as for the laparoscopic surgery, but there is only one large incision made in the lower stomach
L., Millan, M., Kreisler, E., & Jaurrieta, E. (2011). Currentstatus of the treatment of acute colonic diverticulitis: a systematic review.Colorectal Disease, 14(1). doi:10.1111/j.1463-1318.2011.02766.x
Most individuals get well by arranging a better diet and the results of this treatment also prevent constipation and the formation of more diverticula. The components of the healthy diet includes fruit, vegetables and grains such as raw apples, peaches, pears, and tangerines, broccoli squash carrots and brussels sprouts, potatoes, baked beans, kidney beans, and lima beans, whole-wheat bread, brown rice, bran flake cereal, and oatmeal (Longstreth). Doctors often advise individuals with diverticulitis to bypass any food that is hard to digest such as: popcorn, corn and seeds, however there is no evidence to coincide with this statement (WebMD). In some cases, surgery is needed in order to correct or treat diverticulitis because the diet does not have the capability of curing it. Subsequently, surgery is the last option and the process involves cleaning the abdomen of bleeding hernias and the removal of infection. If the disease reoccurs a
Diverticular disease has two separate manifestations. The subtle signs and symptoms of diverticulosis are important to understand because many people who have this problem are asymptomatic, but often this diverticular disease can lead to a more serious condition known as diverticulitis. In diverticulosis, there are diverticula present, but they do not cause any symptoms. In diverticulitis, which will be discussed in detail, the diverticula are inflamed which can lead to other serious consequences for the patient (Gramse, 1983). Diverticulitis is a bugling protrusion of a mucous membrane through the wall of the colon (Marrs, 2006). These saclike or pouch protrusions have the potential to cause inflammation, obstruction, infection, and
A further study of patients under 40 years of age with diverticulitis showed higher than average amounts of sub- cutaneous and intraabdominal fat. More than half of the young patients with diverticulitis were obese. There has been no study as of yet on how the young obese patient with diverticula compares to a young diverticula patient that is not obese. Early CT scans of young obese patients could clarify the diagnosis and prevent unnecessary
diverticulitis. The patient has no diet regimen, which may be the likely cause of his