Diverticulosis (cont.)

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What are the more serious complications of diverticulitis?

More serious complications of diverticulitis include:

  • Collections of pus (abscess) in the pelvis where the diverticulum has ruptured
  • Colonic obstruction
  • Generalized infection of the abdominal cavity (bacterial peritonitis)
  • Bleeding into the colon

A diverticulum can rupture, and the bacteria within the colon can spread into the tissues surrounding the colon (diverticulitis). Constipation or diarrhea also may occur. A collection of pus can develop around the ruptured diverticulum, leading to formation of an abscess, usually in the pelvis. Inflammation surrounding the colon also can lead to colonic obstruction. Infrequently, a diverticulum ruptures freely into the abdominal cavity causing a life threatening infection called peritonitis. On rare occasions, the inflamed diverticula can erode into the urinary bladder, causing bladder infection and passing of intestinal gas in the urine.

Diverticular bleeding occurs when the expanding diverticulum erodes into a blood vessel within the diverticulum. Rectal passage of red, dark or maroon-colored blood and clots occur without any associated abdominal pain if there is no diverticulitis, but bleeding into the colon also may occur during and episode of diverticulitis. Blood from a diverticulum of the right colon may be black in color. Bleeding may be continuous or intermittent, lasting several days.

Patients with active bleeding usually are hospitalized for observation. Intravenous fluids are given to support the blood pressure. Blood transfusions are necessary for those with moderate to severe blood loss. In a rare individual with brisk and severe bleeding, the blood pressure may drop, causing dizziness, shock, and loss of consciousness. In most patients, bleeding stops spontaneously and they are sent home after several days in the hospital. Patients with persistent, severe bleeding require surgical removal of the bleeding diverticula.

Medically Reviewed by a Doctor on 3/18/2014

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