CASE STUDY: ACUTE DIVERTICULITIS
Requirements:
Read the case study below and answer the questions related to the case scenario and support your response with at least one evidence-based reference. You must use at least one scholarly reference to provide pathophysiology statements. Use of the McCance textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.
Case Scenario:
An 84- year-old -female who has a history of diverticular disease presents to the clinic with left lower quadrant (LLQ) pain of the abdomen that is accompanied by with constipation, nausea, vomiting and a low-grade fever (100.20 F) for 1 day.
• On physical exam the patient appears unwell. She has signs of dehydration (pale mucosa, poor skin turgor with mild hypotension [90/60 mm Hg] and tachycardia [101 bpm]). The remainder of her exam is normal except for her abdomen where the NP notes a distended, round contour. Bowel sounds are faint and very hypoactive. She is tender to light palpation of the LLQ but without rebound tenderness. There is hyper-resonance of her abdomen to percussion.
The following diagnostics reveal:
• Stool for occult blood is positive.
• Flat plate abdominal x-ray demonstrates a bowel-gas pattern consistent with an ileus.
• Abdominal CT scan with contrast shows no evidence of a mass or abscess. Small bowel in distended.
Based on the clinical presentation, physical exam and diagnostic findings, the patient is diagnosed with ACUTE DIVERTICULITIS and she is admitted to the hospital. She is prescribed intravenous antibiotics and fluids (IVF). Her symptoms improved and she could tolerate a regular diet before she was discharged to home.
Case Study Questions:
1. Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
2. Identify the clinical findings from the case that supports a diagnosis of acute diverticulitis.
3. List 3 risk factors for acute diverticulitis.
4. Discuss why antibiotics and IV fluids are indicated in this case.
*Scholarly source: U.S. based peer reviewed journals geared for clinicians (MD/DO/NP/PA) published in the past five years or the latest edition of a clinical practice guideline. All scholarly, peer-reviewed research articles must be current – within a 5-year time frame.
References
McCance, K.L. & Huether, S.E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier Health Sciences.
• Chapter 42: Alterations in Digestive Function.
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