Changing Paradigms in the Management of Acute Uncomplicated Diverticulitis

Abstract

Left-sided colonic diverticulitis is a common condition with significant morbidity and health care costs in Western countries. Acute uncomplicated diverticulitis which is characterized by the absence of organ dysfunction, abscesses, fistula, or perforations accounts for around 80% of the cases. In the last decades, several traditional paradigms in the management of acute uncomplicated diverticulitis have been replaced by evidence-based routines. This review provides a comprehensive evidence-based and clinical-oriented overview of up-to-date diagnostics with computer tomography, non-antibiotic treatment, outpatient treatment, and surgical strategies as well as follow-up of patients with acute uncomplicated diverticulitis.

Quality-of-Life and Recurrence Outcomes Following Laparoscopic Elective Sigmoid Resection vs Conservative Treatment Following Diverticulitis

“…No longer based primarily on number of attacks, colectomy is generally recommended for complicated diverticulitis, whereas patients with recurrent uncomplicated disease merit individualized discussion and shared decision-making. 1 The risks of surgery are well established, 2 but the benefits are less clear. Therefore, the burden of proof falls on us: does surgery improve short-and longterm gastrointestinal function in patients with multiple episodes of diverticulitis?…”

“…Acute diverticulitis is a common reason to seek emergency medical attention . At least two-thirds of the episodes are uncomplicated, but a subset of patients present with complicated diverticulitis .…”

“…A cute diverticulitis is a common reason to seek emergency medical attention. 1 At least two-thirds of the episodes are uncomplicated, but a subset of patients present with complicated diverticulitis. 2 Although uncomplicated diverticulitis does not require antibiotic treatment and rarely causes significant morbidity or mortality, 3,4 it has a tendency to recur [5][6][7] or develop into persistent painful diverticulitis.…”

Risk for colorectal cancer after computed tomography verified acute diverticulitis: A retrospective cohort study with long-term follow-up

“…9,10 Recently, it has been suggested that colonoscopy might not be necessary after an episode of uncomplicated acute diverticulitis, but it is indicated in patients with complicated disease. 11–15 However, in the literature, there are few studies with long-term follow-up on this issue. 16…”

“…9,10 Recently, it has been suggested that colonoscopy might not be necessary after an episode of uncomplicated acute diverticulitis, but it is indicated in patients with complicated disease. [11][12][13][14][15] However, in the literature, there are few studies with long-term follow-up on this issue. 16 The objective of this study was to analyze whether further colonic examination is worthwhile for ruling out malignancy after CT-diagnosed acute diverticulitis.…”