V is a saclike herniation of the lining of the

bowel that extends through a defect in

the muscle layer. Diverticula may occur
anywhere in the small intestine or colon
but most commonly occur in the sigmoid
colon (at least 95%)
V Diverticulitis is a condition in which
diverticuli in the colon rupture. The
rupture results in infection in the tissues
that surround the colon.
V The colon (large intestine) is a long tube-like
structure that stores and then eliminates waste
material. Pressure within the colon causes
bulging pockets of tissue (sacs) that push out
from the colonic walls as a person ages. A
small bulging sac pushing outward from the
colon wall is called a à
 . More than
one bulging sac is referred to in the plural as
à
  . Diverticula can occur throughout
the colon but are most common near the end
of the left colon referred to as the sigmoid
colon. The condition of having these diverticula
in the colon is called à
 
 .
V common in the Western world but is
extremely rare in areas such as Asia and
Africa.
V seen in more than fifty percent of people
over the age of 60 years in the United
States
V!

V



V


V The muscular wall of the colon grows thicker with age,
although the cause of this thickening is unclear. It may
reflect the increasing pressures required by the colon to
eliminate feces. For example, a diet low in fiber can lead
to small, hard stools which are difficult to pass and which
require increased pressure to pass. The lack of fiber and
small stools also may allow segments of the colon to close
off from the rest of the colon when the colonic muscle in
the segment contracts. The pressure in these closed-off
segments may become high since the increased pressure
cannot dissipate to the rest of the colon. Over time, high
pressures in the colon push the inner intestinal lining
outward (herniation) through weak areas in the muscular
walls. These pouches or sacs that develop are called
diverticula.
V ARIUM ENEMA X-RAY STUDIES
V COMPUTED TOMOGRAPHY SCAN
V PHYSICAL EXAMINATION (RECTAL EXAM)
V ANGIOGRAPHY or RADIONUCLIDE
V COMPLETE LOOD COUNT
V STOOL EXAM
V u. Assess for personal and family history,
congenital defects, previous abdominal
trauma.
V 2. Collect information of complaints that
brought client to the hospital.
V 3. Obtain history of onset and
progression of symptoms.
V * Nausea and sometimes vomiting.
V * elly pain, usually in the lower left side,
that is sometimes worse when you move.
This is the most common symptom.
V * Fever and chills.
V * loating and gas.
V * Diarrhea or constipation
V * Not feeling like eating
4. Obtain information of signs of bowel
inflammatory process, obstruction, or GI
bleeding
5. Perform complete physical assessment
including vital signs, signs of dehydration,
GI bleeding and acute abdomen.
6. Assess diagnostic tests and procedures
for abnormal values.
V Chronic constipation
V Signs of acute diverticulosis are bowel
irregularity and intervals of diarrhea
V abrupt onset of crampy pain in the left
lower quadrant of the abdomen, and a
low-grade fever
V nausea and anorexia
V some bloating or abdominal distention
V repeated local inflammation of the
diverticula, the large bowel may narrow
with fibrotic strictures, leading to cramps,
narrow stools, and increased constip
V Weakness, fatigue,
V Peritonitis
V abscess formation, and bleeding
V inflamed diverticulum
V Abdominal pain, a rigid boardlike
abdomen, loss of bowel sounds,
V signs and symptoms of shoc
V Noninflamed or slightly inflamed
diverticula
V barium enema x-ray study or by
colonoscopy
V computed tomography
V physical examination,
V rectal examination
V angiography or radionuclide scans
V blood tests
V stool check for blood
V Abdominal X-ray
V , rest, analgesics and antispasmodics are
recommended
V the diet is clear liquid until the
inflammation subsides
V high-fiber, low fat is recommended
V A bulk-forming laxative also is prescribed
V road-spectrum antibiotics
V Oral intake is increased as symptoms
subside.
V è One-stage resection - in which the
inflamed area is removed and a primary
end-to-end anastomosis is completed

V Multiple-staged procedures for

complications such as obstruction or
perforation -
V auscultation for the presence and
character of bowel sounds and
palpation for lower left quadrant pain,
tenderness, or firm mass

V The stool is inspected for pus, mucus, or

blood. It is important to monitor
temperature, pulse, and blood pressure
for abnormal variations.
V NURSING DIAGNOSES
ased on the assessment data, the nursing
diagnoses may includethe following:

V è Constipation related to narrowing of

the colon from thickened muscular
segments and strictures
V è Acute pain related to inflammation
and infection