Diverticulitis physical examination

Patients with diverticulitis usually appear toxic due to pain. Common physical examination findings include tachycardia, fever, abdominal tenderness, guarding and rebound tenderness, and presence of a palpable mass. Diverticulitis diagnosis depends on taking a proper history and performing a physical examination. The known diagnostic criteria for diverticulitis include abdominal tenderness, especially in the left lower quadrant, and leukocytosis. CT scan findings help in disease confirmation.

Patients with acute diverticulitis usually present with the following:^[1]

• Abdominal pain and left quadrant tenderness in physical examination.
• Leukocytosis in the lab findings.
• CT scan confirms the disease. It usually shows dilated loops, extra-colonic air in case of fistula, abscess, and air fluid level.

• Patients with diverticulitis appear toxic due to pain and infection.

• Tachycardia
• Fever

Abdominal examination in the diverticulitis cases shows the following:^[2]

• Abdominal tenderness in the left lower quadrant. It rarely occurs on the right side.
• Guarding or rebound tenderness may be present.
• A palpable mass may be felt.
• Bowel sounds:
  • Usually decreased
  • Normal in the mild cases
  • Increased in cases of intestinal obstruction
• Mass may be palpable on rectal examination

• As a result of the colonic inflammation, bladder inflammation may occur in a small percentage of the patients. Clinical manifestations of cystitis will appear.^[3]

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