The clinical presentation of diverticulitis depends on the location of the affected diverticulum, the severity of the inflammatory process, and the presence of complications. Presenting complaints include the following:
Left lower quadrant pain (70% of patients)
Change in bowel habits
Nausea and vomiting
Constipation
Diarrhea
Flatulence
Bloating
Physical findings in patients with diverticulitis mirror the severity of the inflammation and the presence of complications, as follows:
In simple diverticulitis, localized abdominal tenderness in the area of the affected diverticula and fever
Left lower quadrant tenderness is most common, as most diverticula occur in the sigmoid colon
Right lower quadrant tenderness, mimicking acute appendicitis, can occur in right-sided diverticulitis
In complicated diverticulitis with abscess formation, a tender palpable mass
Elderly patients and some patients taking corticosteroids may have unremarkable findings, even in the presence of severe diverticulitis