Which examination finding is indicative of acute diverticulitis?

The presence of significant tenderness with slight guarding is indicative of acute diverticulitis. In this condition, inflammation occurs in the diverticula, small pouches that can form in the walls of the colon. This inflammation often leads to abdominal pain, particularly in the lower left quadrant, which may be accompanied by tenderness when pressure is applied.

When slight guarding is present, it suggests that the patient is subconsciously tensing the abdominal muscles in response to pain, indicating irritation or inflammation in the underlying structures. This finding is consistent with an acute inflammatory process, as the body attempts to protect the area of discomfort.

Auscultation of hyperactive bowel sounds may occur in various gastrointestinal conditions but is not specific to acute diverticulitis. Normal abdominal examination would suggest that there are no significant findings, which would not be consistent with the diagnosis of diverticulitis. Significant tenderness, without guarding, might indicate a less severe issue but lacks the protective muscle response seen in acute cases, making it less suggestive of the condition.