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Diverticulitis of large intestine with perforation and abscess with bleeding

ICD10CM code
#### Name of the Condition
- Diverticulitis of Large Intestine with Perforation and Abscess with Bleeding
- ICD-10 Code: K57.21

#### Summary
- Diverticulitis is a condition where small, bulging pouches (diverticula) in the digestive tract become inflamed or infected. This specific type involves perforation (tear), the presence of an abscess, and bleeding, making it a complex and severe form of diverticulitis.

#### Causes
- The exact cause of diverticulitis is unclear, but it often results from a combination of genetic predisposition, dietary habits low in fiber, and increased pressure within the colon, leading to the formation of diverticula, which can become inflamed or infected.

#### Risk Factors
- Age (more common in people over 40)
- Low-fiber diet
- Sedentary lifestyle
- Obesity
- Smoking
- Certain medications (e.g., NSAIDs, steroids)
- Family history of diverticulitis.

#### Symptoms
- Severe abdominal pain, usually on the lower left side
- Fever and chills
- Nausea or vomiting
- Changes in bowel habits (constipation or diarrhea)
- Blood in stool or rectal bleeding

#### Diagnosis
- Physical examination and medical history
- Imaging tests like CT scans are crucial for confirming diverticulitis with perforation and abscess.
- Blood tests to check for infection and inflammation.

#### Treatment Options
- Antibiotics to treat infection
- Pain relievers for symptom management
- Surgery may be needed to repair a perforation or drain an abscess
- Temporary dietary adjustments, progressing from liquids to a low-fiber diet, then gradually introducing high-fiber foods.

#### Prognosis and Follow-Up
- With prompt treatment, the prognosis can be favorable, but it often requires hospitalization and potential surgery.
- Regular follow-ups are crucial to monitor recovery and prevent recurrence.
- Chronic cases may necessitate further intervention or surgery.

#### Complications
- Peritonitis (infection of the abdominal lining)
- Fistula formation
- Bowel obstruction
- Sepsis

#### Lifestyle & Prevention
- Increasing dietary fiber intake
- Regular physical activity
- Adequate hydration
- Avoiding smoking
- Managing weight
- Routine screenings for individuals at high risk

#### When to Seek Professional Help
- Intense abdominal pain lasting more than a few hours
- Noticeable changes in bowel movements or the presence of blood
- Unexplained fever and chills

#### Additional Resources
- American Gastroenterological Association: [www.gastro.org](https://www.gastro.org)
- National Institute of Diabetes and Digestive and Kidney Diseases: [www.niddk.nih.gov](https://www.niddk.nih.gov)

#### Tips for Medical Coders
- Ensure thorough documentation to differentiate between uncomplicated and complicated diverticulitis forms.
- Verify details about the presence of perforation, abscess, or bleeding to assign the correct ICD-10 code.
- Common error: Misclassification of diverticular disease types, so always confirm clinical findings.

Medical Policies and Guidelines for Diverticulitis of large intestine with perforation and abscess with bleeding

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