Acute Diverticulitis: A Case Study Essay.
A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent colonoscopy after his acute diverticulitis resolved. Colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon.Acute Diverticulitis: A Case Study Essay.
Develop a 1-2 page case study analysis:
Explain why you think the patient presented with the symptoms described.
Identify the genes that may be associated with the development od the disease.
Explain the process of immunosuppression and the effect it has on the body systems.
**The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references.
Diverticular refers to small, bulging pouches that form within the lining of a person’s digestive system. Said pouches would typically present in the lower parts of the large intestine. The pouches are more common among individuals among the age of forty, seldom resulting in any complications or problems. The mild form of this disease can be treated with changes in diet, rest, and antibiotics. Recurring or severe diverticulitis may, however, require surgery. Symptoms of the disease include pain that may persist and be constant for several days. This pain will often present in the lower left side of the abdomen as in the patient. Other symptoms are nausea and vomiting, abdominal tenderness, fever, and constipation (Kamal et al., 2019).Acute Diverticulitis: A Case Study Essay.
The pathophysiology of diverticulitis can best explain why the patient presented with the symptoms reported. The condition occurs when the mucosa of diverticula becomes inflamed. The inflammation could result in obstruction of the diverticula, for instance, by a fecolith or inspissated feces resulting in bacterial growth, toxin and gas production, and injury to the mucosa. There is also inflammation in the colon’s flat mucosa that separates the diverticula and the orifices, with changes of the disease’s varying severity being difficult to distinguish fromCrohn’s disease. The mucosa’s resulting changes include mucin depletion,a dense lymphoplasmacytic infiltrate,cryptitis, architectural distortion,crypt abscesses,Paneth cell metaplasia, gland dropout, and ulceration. Meanwhile, disease complications includeulceration, abscess formation, bleeding, perforation, fistulas,penetration, stricture formation, and pylephlebitis (Espinosaet al., 2017).Acute Diverticulitis: A Case Study Essay.
Research has shown signs of both environmental and genetic factors playing a role in patient susceptibility to diverticulitis. Twin and family studies have suggested that genetic predisposition to the condition may account for between 43% and 53% of the disease’s incidences. However, genetic research has shown that only TNFSF15 has been associated with the pathogenesis of diverticulitis. The presence of rare, highly penetrant variants that predispose a person to this disease has been suggested by cases of familial incidence with an early age of onset. For this reason, the identification of families with more than one individual suffering from an early onset of this condition would provide a chance for the investigation of the disease’s genetic basis (Tursi et al., 2020).Acute Diverticulitis: A Case Study Essay.
The diagnosis and treatment of this disease in patients also suffering from immunosuppression has been found to be more challenging than in patients that are immunocompetent. The above phenomenon is a function of the fact that maintenance immunosuppressive therapies could mask the symptoms of diverticulitis or impair a patient’s ability to counteract the systemic and local infective sequelae of the disease. In patients that are immunocompromised, diverticulitis is of particular clinical importance. This is because these patients have shown trends of higher mortality and morbidity from the disease than the overall population. Patients that are immunocompromised tend to present later than immunocompetent patients, and they may also have less impressive findings on CT scan and physical exam. Such patients are more likely to have more complications and to fail non-operative management (Espinosaet al., 2017).Acute Diverticulitis: A Case Study Essay.
As this response has shown, the patient’s subjective and objective data point to the differential diagnosis of diverticulitis. The patient may have the disease as a result of a genetic component relating to his grandfather’s disease. Furthermore, the recurrent nature of the patient’s disease suggests that non-operative management will not be sufficient.Acute Diverticulitis: A Case Study Essay.