Learn about diverticulitis with abscess, including colonic diverticulitis with abscess and sigmoid diverticulitis with abscess. This resource provides information on diagnosis, clinical documentation, and medical coding for diverticulitis with abscess, supporting accurate healthcare record keeping and appropriate billing. Find details on symptoms, treatment, and complications of diverticulitis with abscess for improved patient care and medical coding accuracy.
Also known as
Diverticular disease of intestine with abscess
Inflamed pouches (diverticula) in the intestine with pus collection (abscess).
Diverticular disease of intestine
Condition characterized by pouches (diverticula) forming in the intestine wall.
Diverticular disease of intestine, unspecified
Diverticular disease of the intestine without specifying the location or complications.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the diverticulitis associated with an abscess?
Yes
Is the location specified (colon or sigmoid)?
No
Is the location specified (colon or sigmoid)?
When to use each related code
| Description |
|---|
| Inflamed colon pouch with pus collection. |
| Inflamed colon pouch, no abscess. |
| Colon pouch inflammation, spread to peritoneum. |
Diverticulitis with abscess can lead to sepsis. CDI should query for sepsis signs/symptoms to ensure accurate coding and reimbursement.
Documentation must specify the location (e.g., sigmoid colon) for proper code assignment. Unspecified location leads to coding errors.
Associated complications like peritonitis or obstruction must be documented and coded separately for accurate reflection of severity.
Q: What are the most effective antibiotic treatment strategies for complicated diverticulitis with abscess, considering both percutaneous drainage and surgical intervention?
A: Antibiotic treatment for complicated diverticulitis with abscess is guided by abscess size and patient stability. For smaller abscesses (<3cm) in stable patients, intravenous antibiotics like piperacillin/tazobactam or a carbapenem plus metronidazole are often sufficient, sometimes followed by oral antibiotics after clinical improvement. Percutaneous drainage is usually considered for abscesses 3-5cm or those not responding to antibiotics alone. For larger abscesses (>5cm) or patients with sepsis, surgical intervention including drainage and potential resection is often necessary alongside broad-spectrum antibiotics. Antibiotic choice should also consider local resistance patterns. Explore how antibiotic stewardship programs can optimize treatment strategies and minimize resistance development in diverticulitis with abscess management. Consider implementing a collaborative approach involving gastroenterology, surgery, and infectious disease specialists for personalized treatment plans.
Q: How can I differentiate between uncomplicated diverticulitis and diverticulitis with abscess formation on CT imaging, and when should I consult a surgeon for diverticulitis with abscess?
A: Differentiating uncomplicated diverticulitis from diverticulitis with abscess on CT requires careful evaluation. Uncomplicated diverticulitis typically presents with bowel wall thickening, inflammation (fat stranding), and possibly small pockets of free air. Diverticulitis with abscess appears as a well-defined fluid collection with enhancing walls, potentially containing gas. Abscess size and location are crucial. While smaller, contained abscesses may be managed medically, surgical consultation is recommended for larger abscesses (>5cm), those not responding to medical therapy, signs of peritonitis, or worsening clinical picture despite antibiotic treatment. Learn more about the specific CT findings indicative of abscess formation and consider implementing a standardized imaging review protocol in your practice for accurate diagnosis and timely surgical referrals.
Patient presents with acute abdominal pain, consistent with diverticulitis with abscess formation. The patient reports localized left lower quadrant pain, often described as sharp or cramping, accompanied by tenderness to palpation. Symptoms include fever, chills, nausea, vomiting, and changes in bowel habits such as constipation or diarrhea. Physical examination reveals localized guarding, rebound tenderness, and possibly a palpable mass. Laboratory findings indicate leukocytosis with a left shift. CT scan of the abdomen and pelvis confirms the diagnosis of diverticulitis with associated pericolonic abscess. Differential diagnoses considered include appendicitis, inflammatory bowel disease, irritable bowel syndrome, and colon cancer. Given the presence of a localized abscess, treatment involves intravenous antibiotics such as metronidazole and ciprofloxacin or a combination like piperacillin-tazobactam. Abscess drainage, either percutaneously or surgically, may be necessary if the abscess does not respond to medical management. Patient education emphasizes the importance of a high-fiber diet, adequate hydration, and follow-up care to prevent recurrent episodes of diverticulitis. The patient is instructed to return for reassessment and potential surgical consultation if symptoms worsen or do not improve with medical therapy. Monitoring for complications such as perforation, fistula formation, or sepsis is essential. ICD-10 code K57.33, Diverticulitis of colon with abscess, is documented.