What should you know about perforated colon diverticulitis?

Diverticula are small pouches that can form in the colon wall. Diverticulitis occurs when a pouch becomes inflamed. If the wall breaks, infection and inflammation can spread around the bowel, causing a collection or widespread abdominal infection. Severe, constant abdominal pain, fever, vomiting, a swollen or tender abdomen, and marked weakness can occur, but symptoms vary. Constipation or diarrhoea may also be present. This is different from uncomplicated diverticular disease and cannot be safely assessed by symptoms alone.

Suspected perforation needs emergency assessment. Do not wait for a routine appointment or try to treat severe pain at home. In hospital, clinicians may examine you, check blood tests and use imaging to assess the bowel and surrounding abdomen. Treatment can include fluids, antibiotics, bowel rest and, when needed, an operation or drainage procedure. Follow the treating team’s instructions about eating, drinking and medicines.

Go to an emergency department immediately for sudden or worsening severe abdominal pain, a rigid or very swollen abdomen, faintness, confusion, persistent vomiting, fever with shaking chills, or difficulty passing stool or gas. Call emergency services if you are too weak to travel safely. These warning signs are urgent because infection can worsen quickly.

Has imaging shown a perforation or collection? Will I need antibiotics, drainage or surgery? When can I eat and drink, and what follow-up or nutrition counselling will support recovery?