Long-term Outcomes After Initial Presentation of Diverticulitis

Rose, John; Parina, Ralitza; Faiz, Omar; Chang, David C.; Talamini, Mark A.

doi:10.1097/sla.0000000000001114

Cited by 86 publications

(71 citation statements)

References 35 publications

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“…There are multiple classification systems for complicated diverticulitis, of which the Hinchey Classification (Table 1) is most widely used [11]. Morris et al [12] performed a systematic review of diverticulitis, including the natural history, and illustrated their findings using a hypothetical cohort of 1,000 patients, which is reproduced, with permission, in Figure 1.This is consistent with a population-based Californian study in which 84% of patients with acute diverticulitis are successfully managed conservatively without them having to experience a second episode [13]. The outcomes of recurrent episodes of acute diverticulitis are particularly relevant for planning long-term management.…”

Section: Introductionsupporting

confidence: 57%

Current Controversies in the Management of Diverticulitis: A Review

Nally

Kavanagh

2018

Dig Surg

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Background: Symptomatic diverticular disease is challenging for patients, clinicians and health services. The prevalence increases with age and BMI and as such, the burden of this disease is set to increase with higher rates of acute presentations already documented. The natural history of recurrent episodes, complications and symptom progression is not fully understood. Furthermore, medical and surgical management strategies are under constant appraisal, debate and evolution. Methods: A review of the contemporary literature was performed to examine the emerging trend towards conservative treatment. Results: Routine use of in-patient, intravenous antibiotics may not be required and outpatient management is possible for certain patients. Universal colonoscopy examination after uncomplicated acute diverticulitis is controversial but is mandatory after complicated episodes. Recent, high-profile, clinical trials suggest that less aggressive surgical management of both acute and chronic presentations may be feasible in some cases. Conclusions: Diverticulitis is a common yet challenging topic that demands clinicians to provide an individualised yet evidence-based approach.

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Section: Introductionsupporting

confidence: 57%

Current Controversies in the Management of Diverticulitis: A Review

Nally

Kavanagh

2018

Dig Surg

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“…The distinction between complicated and uncomplicated disease has been routinely applied to colonic diverticulitis for many years [1]. Numerous classifications have been developed to categorize the complicated disease [2] and its surgical treatment [3], but when it comes to symptomatic uncomplicated diverticular disease, it is still difficult to give a clear definition and provide the correct surgical indication [4]. Some authors have described symptomatic uncomplicated diverticular disease as the presence of active disease without episodes of colonic perforation and therefore without the development of pericolic abscesses [5,6].…”

Section: Introductionmentioning

confidence: 99%

Symptomatic Uncomplicated Diverticular Disease and Incidence of Unexpected Abscess during Sigmoidectomy: A Multicenter Prospective Observational Study

Mari¹,

Crippa

Borroni

et al. 2019

Dig Surg

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Background: Symptomatic uncomplicated diverticular disease can affect patients' everyday routine. Considerable efforts have been made to identify clinical features that correlate to the severity of the disease. Unexpected intraoperative abscesses are reported in large retrospective series, showing how uncomplicated symptoms and presentations can underlie a complicated disease. The aim of this study was to investigate the incidence of pericolic or intramural abscess in patients undergoing elective sigmoidectomy for symptomatic uncomplicated diverticular disease and see if chronic symptoms correlate to the presence of an abscess. Meth-

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“…But surgery still seems to play an important role. For example, Rose et al [68] found recently that the mortality rate of delayed elective surgical intervention after the first episode of emergent diverticulitis was 0.3% compared with 4.6% for emergent resection during a second episode. Currently, the main question is when elective resection has to be advised.…”

Section: Surgerymentioning

confidence: 97%

New medical strategies for the management of acute diverticulitis

Tursi

2015

Expert Review of Gastroenterology & Hepatology

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Acute diverticulitis, defined as acute inflammation of a colonic diverticulum, is a common emergency presentation managed by both surgeons and physicians. There have been advances in the medical treatments offered to patients in recent years. Factors predisposing individuals to the development of acute diverticulitis include obesity, smoking, lack of physical activity and medication use, such as NSAIDs. Although widely used, there is limited evidence on the efficacy of individual antibiotic regimens and antibiotic treatment may not be required in all patients. Mesalazine seems to be the only effective treatment for the primary prevention of acute diverticulitis. Finally, evidence of effective measures for the prevention of recurrence is lacking. Furthermore, high-quality randomized controlled trials are required for medical treatments in patients with acute diverticulitis, if management is to be evidence based.

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Long-term Outcomes After Initial Presentation of Diverticulitis

Cited by 86 publications

References 35 publications

Current Controversies in the Management of Diverticulitis: A Review

Current Controversies in the Management of Diverticulitis: A Review

Symptomatic Uncomplicated Diverticular Disease and Incidence of Unexpected Abscess during Sigmoidectomy: A Multicenter Prospective Observational Study

New medical strategies for the management of acute diverticulitis

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