Contemporary Review of Risk‐Stratified Management in Acute Uncomplicated and Complicated Diverticulitis

Boermeester, Marja A.; Humes, David J.; Velmahos, George C.; Søreide, Kjetil

doi:10.1007/s00268-016-3560-8

Cited by 35 publications

(28 citation statements)

References 58 publications

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“…The utility of antimicrobial therapy in acute uncomplicated diverticulitis has been a point of controversy in the international medical community [93]. In terms of clinical resolution, recent investigation demonstrates that antimicrobial treatment was not superior to withholding antibiotic therapy in patients with mild, unperforated diverticulitis.…”

Section: Acute Left Colonic Diverticulitismentioning

confidence: 99%

The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

et al. 2017

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Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide.The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important.In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs.The aim of this paper is to promote global standards of care in IAIs and update the 2013 WSES guidelines for management of intra-abdominal infections.

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Section: Acute Left Colonic Diverticulitismentioning

confidence: 99%

The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

et al. 2017

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“…Uncomplicated diverticulitis has traditionally been treated with antibiotics, and several studies have shown that treatment in an out-patient setting is safe [12]. Recent studies have suggested that uncomplicated diverticulitis can be managed without antibiotic treatment in a hospital setting [13]. It is unclear how this may be transferred to primary care, since a CT scan verified the diagnosis in all patients.…”

Section: Treatmentmentioning

confidence: 99%

Diverticular Disease in the Primary Care Setting

Wensaas

Hungin

2016

Journal of Clinical Gastroenterology

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Diverticular disease is a chronic and common condition, and yet the impact of diverticular disease in primary care is largely unknown.The diagnosis of diverticular disease relies on the demonstration of diverticula in the colon, and the necessary investigations are often not available in primary care. The specificity and sensitivity of symptoms, clinical signs and laboratory tests alone are generally low and consequently the diagnostic process will be characterized by uncertainty. Also, the criteria for symptomatic uncomplicated diverticular disease in the absence of macroscopic inflammation are not clearly defined. Therefore both the prevalence of diverticular disease and the incidence of diverticulitis in primary care are unknown.Current recommendations for treatment and follow-up of patients with acute diverticulitis are based on studies where the diagnosis has been verified by computerized tomography. The results cannot be directly transferred to primary care where the diagnosis has to rely on the interpretation of symptoms and signs. Therefore, one must allow for greater diagnostic uncertainty, and safety netting in the event of unexpected development of the condition is an important aspect of the management of diverticulitis in primary care.The highest prevalence of diverticular disease is found among older patients, where multimorbidity and polypharmacy is common. The challenge is to remember the possible contribution of diverticular disease to the patient's overall condition and to foresee its implications in terms of advice and treatment in relation to other diseases.

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“…For all IAIs, the presence of sepsis or septic shock is a generic prognostic feature and defines a disease process that has become systemic, rather than a localized disease process. Several disease specific scores exist for various organ-related IAIs (appendicitis, diverticulitis, perforated ulcers) [49][50][51][52], for which none have good accuracy, prediction ability, nor validity and generalizability.…”

Section: Statementmentioning

confidence: 99%

Management of Intra-Abdominal Infections

Moore

2016

Common Problems in Acute Care Surgery

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This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings.

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Contemporary Review of Risk‐Stratified Management in Acute Uncomplicated and Complicated Diverticulitis

Cited by 35 publications

References 58 publications

The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

Diverticular Disease in the Primary Care Setting

Management of Intra-Abdominal Infections

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