Colonic diverticulitis. Recognizing and managing its presentations and complications.

Diverticulitis usually manifests as pain of abrupt onset in the lower left quadrant. Complications may occur with or without an acute attack. Plain abdominal films are crucial for initial workup and follow-up. Endoscopic examination is often indicated, but barium enema study should usually be avoided during an acute attack. Computed tomography offers the best means of determining extracolonic extension of diverticulitis. Therapy is usually medical and consists of "resting" the bowel, administering antibiotics to resolve infection, and preventing or minimizing complications. Surgery is reserved for refractory, recurrent, or complicated disease.