OBJECTIVES - Diverticula of the colon

The student should be able to:

Outline the theories on the aetiology of diverticula of the colon including age, diet and vascular anatomy of the colon.

Describe the morphology and pathological consequences of diverticula of the colon.

Describe the clinical features of diverticula of the colon, differentiating the symptoms and signs of diverticulosis from diverticulitis including signs of inflammation and bleeding.

Describe the management of a patient with asymptomatic diverticula of the colon.

Outline the complications of diverticula of the colon including bleeding, obstruction, perforation and fistula formation.

Discuss the investigation of a patient with left lower quadrant pain and fever including:

a) a list of the differential diagnosis

b) outline the steps in assessing and stabilising the patient's condition.

c) discuss appropriate diagnostic studies including abdominal films, ultrasound, sigmoidoscopy and barium enema.

d) describe the treatment of such a patient, including the indications for antibiotics, drainage and resection.
In a patient with massive rectal bleeding outline a plan of management, including the

a) differential diagnosis

b) outline the steps in assessing and stabilising the patient's condition.

c) discuss appropriate diagnostic studies

d) discuss the natural history of each lesion that might be causing the bleeding and outline the preferred treatment for each.

Describe the treatment of a patient with diverticulitis including indications for antibiotics, drainage and resection.

Describe the possible sites of fistula formation seen in diverticular disease and outline their presentation and management including colovescical, colovaginal, coloenteric and colocutaneous fistulae.