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bowels
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a milycroperforation, most like walled off by adjacent structures, may present with no systemic signs of illness or infection. on the other hand, disease may progress from a localized and walled-off process to one with peridiverticular inflammatory phlegmon and localized abscess. systemic signs of infection (eg, fever) then develop. because diverticula and, hence, diverticulitis can develop anywhere in the gastrointestinal tract, symptoms may mimic multiple conditions. diverticulitis in the right colon or in a redundant sigmoid colon may be mistaken for acute appendicitis. diverticulitis in the transverse colon may mimic peptic ulcer disease, pancreatitis, or cholecystitis. retroperitoneal involvement may present similar to renal disease. in women, lower quadrant pain may be difficult to distinguish from a gynecological process. more severe diverticulitis is often accompanied by anorexia, nausea, and vomiting. typically, the pain is localized and severe and present for several days prior to presentation. altered bowel habits, especially constipation, are reported by most patients. a small percentage of patients may complain of urinary symptoms, such as dysuria, urgency, and frequency, due to inflammation adjacent to urinary tract structures. macroperforation with spillage of colonic contents into the peritoneum leads to generalized abdominal pain and peritonitis. leg pain possibly associated with a thigh abscess and leg emphysema secondary to retroperitoneal perforation from diverticulitis have been reported
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