Will right versus left acute colonic diverticulitis location affect the likelihood of emergent operation?

Abstract

Purpose Modified Hinchey classification with computed tomography (CT)providesa good predictive factorfor medical failure. By using CT, the location of diverticulitis is proved as an important factor for medical treatment and right-sided diverticulitis is successfully treated medicallymore. However, will more accurate location for diverticulitis affect treatment is not evaluated. Methods Patients who were diagnosed withacute colonic diverticulitis by abdominopelvic CT were retrospectively recorded and analyzed.Patient demographics and clinical features were obtained from patients’ records.Abdominopelvic CT findings were categorized using the location in the colon, distribution of free air in the bowel lumen, fluid accumulation, and type of extra-luminal free air. RESULTS Patients with right-sided diverticulitis were more likely to be younger and elevation of C-reactive protein (CRP) in patients with left-sided diverticulitiswithout significantly different.Only 6.3% of patients received surgical treatment and left-sided diverticulitis is more suitablefor operation (P = 0.02).Most patients with local free air underwent successful medical treatment. The distribution of diverticulitis is different between right- and left-sided diverticulitis and lateral distribution included more cases of surgery. CONCLUSIONS Although there wasno statistical difference between location and emergent operation, we observed that location in the lateral region was an indicatorfor emergent operation. Right-and left-sided diverticulitis manifest indifferent locations, which maybe one of the causes of medical treatmentfailure. Asfeweremergent operations have been performed in recent years, we suggest conducting additionalstudies with larger cohortsto confirm the relationship between location and surgery.