Page 259 - 2021 IDMT Digital

DIVERTICULITIS
Introduction:
• Inflammation RI D FRORQLF GLYHUWLFXOXP may have D ODUJH range of severity:
o /RFDO LQIODPPDWLRQ PLOG GLVHDVH
o $EVFHVV
o 3HUIRUDWLRQ RU ILVWXOD
o 3HULWRQLWLV VHYHUH GLVHDVH

Subjective:
• 6LJQV DQG 6\PSWRPV
o $FXWH DEGRPLQDO SDLQ LQ WKH //4
o 1DXVHD DQG YRPLWLQJ
o &RQVWLSDWLRQ RU ORRVH VWRROV PD\ EH SUHVHQW
o %OHHGLQJ LV XQFRPPRQ
Objective:
• 3K\VLFDO ([DP
o 9LWDO VLJQV IHYHU
o $EGRPLQDO H[DP
ƒ 3HULWRQHDO VLJQV PD\ EH SUHVHQW UHERXQG JXDUGLQJ
ƒ //4 WHQGHUQHVV DQG SRVVLEOH PDVV PD\ EH QRWHG ZLWK SDOSDWLRQ
ƒ $EGRPLQDO GLVWHQWLRQ
Assessment:
• 'LIIHUHQWLDO
o $SSHQGLFLWLV DFXWH LQIODPPDWLRQ RI YHUPLIRUP DSSHQGL[ SUHVHQWV ZLWK SDLQ LQ WKH
5/4
o OYDULDQ torsion VXGGHQ VHYHUH SDLQ LQ ULJKW RU OHIW ORZHU DEGRPLQDO
TXDGUDQWV LQ IHPDOHV
o 5XSWXUHG HFWRSLF SUHJQDQF\ VHYHUH SDLQ SHOYLF WHQGHUQHVV VKRFN SRVLWLYH
+&*
o ,%' VHYHUH DEGRPLQDO SDLQ ZLWK EORRG\ GLDUUKHD PD\ KDYH SRVLWLYH IDPLO\
KLVWRU\
o %DFWHULDO JDVWURHQWHULWLV GLDUUKHD ZLWK PRUH VHYHUH V\PSWRPV PD\ KDYH D IHYHU
DQG EORRG\ GLDUUKHD
Plan:
• 0LOG V\PSWRPV QR SHULWRQHDO VLJQV DQG D SUHVXPSWLYH GLDJQRVLV RI GLYHUWLFXOLWLV HPSLULF
PHGLFDO WKHUDS\
o 3RVVLELOLWLHV LQFOXGH
ƒ $PR[LFLOOLQ DQG FODYXODQDWH SRWDVVLXP
ƒ 0HWURQLGD]ROH SOXV HLWKHU FLSURIOR[DFLQ RU WULPHWKRSULP VXOIDPHWKR[D]ROH
• 6HYHUH V\PSWRPV RU ³UHG IODJV´ (9$& RU WUDQVIHU VXUJLFDO FRQVXOWDWLRQ QHFHVVDU\

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