From the Research
For an elderly patient with diverticulitis presenting with diarrhea and vomiting, essential laboratory tests include complete blood count (CBC) to assess for leukocytosis, comprehensive metabolic panel (CMP) to evaluate kidney function, electrolytes, and liver enzymes, C-reactive protein (CRP) to measure inflammation, and stool studies to rule out other causes of diarrhea, as supported by the most recent study 1. The diagnosis and management of diverticulitis in older adults is a complex issue, with a high risk of complications and mortality. Key laboratory tests that should be ordered include:
- Complete blood count (CBC) to assess for leukocytosis (elevated white blood cells) indicating infection
- Comprehensive metabolic panel (CMP) to evaluate kidney function, electrolytes, and liver enzymes
- C-reactive protein (CRP) to measure inflammation
- Stool studies including culture, ova and parasites, and C. difficile testing to rule out other causes of diarrhea
- Urinalysis to exclude urinary tract infection as a source Imaging is also crucial, with CT scan of the abdomen and pelvis with IV contrast being the gold standard to confirm diverticulitis and assess for complications like abscess or perforation, as recommended by 2. The elderly are particularly vulnerable to dehydration and electrolyte imbalances from diarrhea and vomiting, so close monitoring of fluid status and electrolytes is essential for appropriate management, as highlighted in 3. It is also important to note that the management of diverticulitis in older adults should focus on what matters most to the patient, providing the most meaningful outcome possible within the context of multimorbidity, patient goals, symptom burden, and anticipated treatment outcomes, as emphasized in 1.