LYCOS RETRIEVER 
Diverticulitis: Patients
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Diverticulitis is three times more likely to occur in the left side of the large intestine. Since most diverticula are located in the sigmoid colon (the final segment of the large intestine which empties into the rectum), most diverticulitis ... takes place in the sigmoid. The elderly have the most serious complications from diverticulitis, although very severe infections can also occur in patients under the age of 50. Men are three times as likely as women to be stricken with diverticulitis.
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Diverticulitis may be a more severe illness in younger patients, in immunocompromised patients, in patients with significant comorbid conditions, and in those taking anti-inflammatory medications. In young patients, an apparent increased severity may be a consequence of delayed diagnosis.
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Diverticulitis develops in approximately twenty five percent of people with diverticulosis. It occurs in the sigimoid colon over 90% of the time. This accounts for the fact that most patients have left lower quadrant abdominal pain. It is ... true, however, that as many as ten percent of patients have no abdominal pain at all. Most of these patients will have urinary symptoms.
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Diverticulitis is usually diagnosed based on medical history, physical examination and blood tests. Most patients display classic signs and symptoms. Therefore, diagnostic imaging tests are oftenunnecessary. However, certain imaging tests (e.g., CAT scan, ultrasound) may be used in some cases.
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Diverticulitis appears to be more common in patients with the largest number of diverticula; 15-20% of those with diverticulosis develop symptomatic diverticulitis. While diverticulitis is generally considered a disease of the elderly population, as many as 20% of patients with diverticulitis are younger than 50 years.
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The incidence of appendiceal diverticulitis in pathologic specimens is 0.004-2.1% and is unusual in younger patients Despite being first described in 1893 this condition is commonly dismissed by surgeons and pathologists as a variant of true appendicitis. However, appendiceal diverticulitis is a discrete clinical process that must be considered in the appropriate setting because of the much higher risk of perforation. The average age is older, the pain is often intermittent, and while can be localized in the right lower abdominal quadrant, is of longer duration. Although no further treatment besides appendectomy is needed, it is important that surgeons be aware of this condition, as the clinical presentation can be different from classical acute appendicitis picture. Patients seek medical treatment much later than those with classic appendicitis and if there is a delay in establishing the correct diagnosis, perforation within the mesentery is found at the time of operation. Also, it is often mistakenly identified as carcinoma and it has higher rate of perforation and a longer convalescence.
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