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Diseases of the Colon &ReCtum Volume 57: 3 (2014) 285 the diagnosis of acute diverticulitis can often be made following a focused history and physical examination, especially in patients with recurrent diverticulitis whose diagnosis has been previously confirmed. the constellation of left lower quadrant tenderness with or without other peritoneal findings, fever, and leukocytosis is suggestive of sigmoid diverticulitis. the presence of fecaluria, pneumaturia, or pyuria raises the suspicion for a colovesical fistula. urinalysis and plain abdominal radiographs are helpful in excluding diagnoses in the differential including urinary tract infections, kidney stones, and bowel obstruction. other diagnoses that can mimic the presentation of acute diverticulitis include irritable bowel syndrome, appendicitis, iBD, ischemic bowel, neoplasia, and gynecologic disorders. in an effort to reduce the misdiagnosis rate among patients with …