ABSTRACT
This chapter presents a case study of a 57-year-old male who is presented with a 12-hour history of worsening, constant left iliac fossa pain associated with fever. Patients with sigmoid diverticulitis present with constant aching left lower quadrant abdominal pain, change in bowel habit and fever. Diverticular disease is a condition where small outpouchings develop in the large bowel, most commonly the sigmoid colon. Classically, abdominal examination demonstrates left iliac fossa tenderness and guarding, hence giving rise to the term 'left-sided appendicitis'. Rectal examination is painful but can help exclude a rectal or low colon cancer. Blood tests will show a leukocytosis and raised inflammatory markers, but these can be normal in a small proportion of patients. Mild uncomplicated acute diverticulitis can be managed as an outpatient with oral antibiotics that cover gut flora. Unwell patients, the elderly or those with very high inflammatory markers should be admitted for inpatient intravenous antibiotic therapy.
