Long-term outcome and management of right colonic diverticulitis in western countries: Multicentric Retrospective Study

Courtot, L.; Bridoux, Valérie; Lakkis, Zaher; Piessen, G.; Manceau, Gilles; Mulliri, Andréa; Meurette, G.; Bouayed, A; Venara, Aurélien; Blanc, B; Tabchouri, Nicolas; Salamé, Ephrem; Ouaïssi, Mehdi

doi:10.1016/j.jviscsurg.2019.01.005

Cited by 15 publications

(27 citation statements)

References 25 publications

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“…A study by Destek et al showed that conservative management of uncomplicated RCD with antibiotics is a safe and effective treatment option [14]. Recently, a multicenter retrospective study also showed that conservative treatment can be used safely and effectively for uncomplicated RCD, with a low recurrence rate of 6.8% [12]. Thus, conservative management can thus be considered a safe treatment option for uncomplicated RCD.…”

Section: Discussionmentioning

confidence: 99%

“…Conservative treatment with intravenous antibiotics and bowel rest is usually recommended for the management of acute uncomplicated RCD in Asia [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, some patients are at risk of exacerbation and emergent surgery need to be performed, in which case right colectomy could be required. Furthermore, about 6.8-20.5% of cases with RCD develop recurrence after conservative management [12,16,17]. Thus, conservative treatment may thus not be the best option for every patient with acute RCD but there is no definitive treatment strategy for acute RCD.…”

Section: Introductionmentioning

confidence: 99%

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Management and long-term outcomes of acute right colonic diverticulitis and risk factors of recurrence

Chen

Zhou

et al. 2022

Preprint

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Background: Acute right-sided colonic diverticulitis (RCD) is a common disease in Asian populations for which the optimal treatment remains controversial. The aim of this study was to investigate management and evaluate long-term outcomes of treatment in patients with acute RCD. Methods: We retrospectively collected and analyzed clinical data for patients with acute RCD admitted to the Tongren Hospital, Shanghai Jiao Tong University School of Medicine from December 2015 to December 2020. The patients were divided into two groups, according to primary treatment strategy, which was either conservative treatment or surgical treatment. Results: A total of 162 consecutive patients with acute RCD were enrolled in the study. There was no significant difference in age, sex, history of abdominal surgery, medical co-morbidities, fever, previous history of RCD, treatment success rate and incidence of complications between the conservative and surgery groups. However, the recurrence rate in conservative groups was significantly higher than in surgery groups (16.53% vs 2.44%, P = 0.020). And more frequent bowel movements and previous history of RCD increased the risk of recurrence of acute RCD. Moreover, there was no significant difference in either treatment success rate or the overall recurrence rate between the patients with uncomplicated diverticulitis and patients with complicated diverticulitis. Conclusions: Surgical treatment is also safe and effective for acute RCD. Surgical treatment should mainly be considered for patients with acute RCD with recurrence risk factors (more frequent bowel movements and previous history of RCD) or with complicated acute RCD.

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Section: Discussionmentioning

confidence: 99%

“…Conservative treatment with intravenous antibiotics and bowel rest is usually recommended for the management of acute uncomplicated RCD in Asia [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management and long-term outcomes of acute right colonic diverticulitis and risk factors of recurrence

Chen

Zhou

et al. 2022

Preprint

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“…15 In the Western world, AD affecting the left side of the colon predominates, and right-sided AD is uncommon. 3,16,17 The epidemiology of RCD and AD show marked geographic variation, and has changed in recent decades. 8,18 Right-sided diverticula are often considered to be congenital; however, more recently this has been questioned.…”

Section: Discussionmentioning

confidence: 99%

“…24,25 However, patients are frequently misdiagnosed as having acute appendicitis, leading to unnecessary surgery. 17,26 In regions with a high incidence of right-sided AD, patients with right lower quadrant pain may be more likely to have preoperative imaging, due to diagnostic uncertainty.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of right‐sided colonic diverticulosis in a New Zealand population

Turner

O’Grady

Senadeera

et al. 2021

ANZ Journal of Surgery

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Background: Once considered to be a congenital condition, the epidemiology of rightsided colonic diverticulosis (RCD) is evolving. Acute diverticulitis (AD) is a complication of RCD which is frequently misdiagnosed as appendicitis, resulting in unnecessary surgery, as there is strong evidence supporting medical management for right-sided AD. In general, the incidence of AD correlates with the prevalence of RCD, which shows marked geographic variation. Few data reporting RCD prevalence come from Western countries, so the aim of this study is to define the prevalence of RCD in a New Zealand population. Methods: Independent review of the imaging from 1000 consecutive patients undergoing a computed tomography Kidney/Ureter/Bladder scan for suspected urolithiasis at Christchurch Hospital between January and November 2017 was undertaken, to determine the presence or absence, and distribution of colonic diverticulosis. Patients were excluded if they had a history of colonic resection, known IBD, or were less than 18-years old.Results: Thirty-one patients were excluded, leaving 969 eligible patients. Overall, 95 patients (9.8%) had RCD identified. The prevalence of RCD increased significantly with advancing age, being present in 2.3% of those aged 18-29, increasing to 20.3% in those greater than 70-years old (p < 0.001). Conclusion:The prevalence of RCD in a New Zealand population is relatively high and increases significantly with age. This adds support to the role of cross-sectional imaging in the evaluation of suspected appendicitis, to exclude right-sided AD. The association with advancing age supports RCD being an acquired condition rather than a congenital condition as was previously thought.

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Right‐sided acute diverticulitis in a North African country: Presentation and management in one surgical center

Jedidi,

Mabrouk,

Ghali

et al. 2024

World j. surg.

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PurposeRight‐sided diverticulitis is a rare entity in North Africa. Therefore, it is usually misdiagnosed, and the management of cecal diverticulitis is aggressive in most cases, whereas nowadays, most studies recommend a conservative approach with promising results. This study aims to describe the presentation, management, and outcomes of right‐sided diverticulitis (RSD) and to present the experience of one surgical center in Tunisia.MethodsThis is a retrospective study including all patients presented with RSD, in the Department of Surgery “A” of the Charles Nicolle Hospital between 2007 and 2021.ResultsForty patients were included in our study. The mean age was 42 years with a standard deviation of 14. The sex ratio was 1.1. Only 2 patients had chronic constipation. All patients presented right‐sided abdominal pain, and only 3 patients had diarrhea. Twenty one patients were diagnosed during surgery. Fourteen patients were treated successfully by conservative management. An operative procedure was performed in 26 cases: 21 had a diverticulectomy (80%), two had an ileal resection (8%), and three had a right colectomy (11.5%). No postoperative events occurred with a short hospital stay (5 ± 3 days). Follow‐up showed no recurrences.ConclusionRight‐sided diverticulitis has a lower incidence and complication rate compared to left‐sided diverticulitis. Conservative treatment has demonstrated favorable outcomes in managing RSD, although the available evidence remains limited.

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Long-term outcome and management of right colonic diverticulitis in western countries: Multicentric Retrospective Study

Cited by 15 publications

References 25 publications

Management and long-term outcomes of acute right colonic diverticulitis and risk factors of recurrence

Management and long-term outcomes of acute right colonic diverticulitis and risk factors of recurrence

The prevalence of right‐sided colonic diverticulosis in a New Zealand population

Right‐sided acute diverticulitis in a North African country: Presentation and management in one surgical center

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