PURPOSE: Acute diverticulitis is the most common presentation of diverticular disease; however, no published guidelines for management are available in the United Kingdom. This survey was designed to assess the current United Kingdom regional practice compared with the guidelines published by The American Society of Colon and Rectal Surgeons. METHODS: A questionnaire survey focused on the management of acute diverticulitis was sent to all consultants, specialist registrars, and staff-grade surgeons in general surgery in one United Kingdom region. RESULTS: Eighty-two questionnaires were returned (80 percent). A majority (80 percent) would request routine blood tests, abdominal, and erect chest x-rays on arrival. Pethidine (56 percent) was the preferred analgesic, followed by morphine (40 percent). Ninety-four percent used an antibiotic combination of second/third-generation cephalosporin and metronidazole. Computerized tomography was the most commonly used initial investigation (42 percent). Forty percent use barium enema and 31 percent use a combination of barium enema and sigmoidoscopy as follow-up investigations. In patients older than aged 50 years, elective resection would be considered by a majority (51 percent) only when complications arose. In those aged 50 years or younger, 35 percent would resect only if complications arose with only 6 percent after a single episode of acute diverticulitis. CONCLUSIONS: There are major differences in the management of patients with acute diverticulitis in our current practice in one United Kingdom region compared with the guidelines published by The American Society of Colon and Rectal Surgeons, which are based on published literature. There is an urgent need to establish similar guidelines in the United Kingdom to improve the clinical outcome of patients with such a common condition.
PURPOSE:Acute diverticulitis is the most common presentation of diverticular disease; however, no published guidelines for management are available in the United Kingdom. This survey was designed to assess the current United Kingdom regional practice compared with the guidelines published by The American Society of Colon and Rectal Surgeons. METHODS: A questionnaire survey focused on the management of acute diverticulitis was sent to all consultants, specialist registrars, and staff-grade surgeons in general surgery in one United Kingdom region. RESULTS: Eighty-two questionnaires were returned (80 percent). A majority (80 percent) would request routine blood tests, abdominal, and erect chest x-rays on arrival. Pethidine (56 percent) was the preferred analgesic, followed by morphine (40 percent). Ninety-four percent used an antibiotic combination of second/third-generation cephalosporin and metronidazole. Computerized tomography was the most commonly used initial investigation (42 percent). Forty percent use barium enema and 31 percent use a combination of barium enema and sigmoidoscopy as follow-up investigations. In patients older than aged 50 years, elective resection would be considered by a majority (51 percent) only when complications arose. In those aged 50 years or younger, 35 percent would resect only if complications arose with only 6 percent after a single episode of acute diverticulitis. CONCLUSIONS: There are major differences in the management of patients with acute diverticulitis in our current practice in one United Kingdom region compared with the guidelines published by The American Society of Colon and Rectal Surgeons, which are based on published literature. There is an urgent need to establish similar guidelines in the United Kingdom to improve the clinical outcome of patients with such a common condition.
Authors: Jeong Yeon Kim; Sung Gil Park; Hee Joon Kang; Young Ah Lim; Kyung Ho Pak; Tae Yoo; Won Tae Cho; Dong Woo Shin; Jong Wan Kim Journal: Int J Colorectal Dis Date: 2019-07-02 Impact factor: 2.571
Authors: Wytze Laméris; Adrienne van Randen; Shandra Bipat; Patrick M M Bossuyt; Marja A Boermeester; Jaap Stoker Journal: Eur Radiol Date: 2008-06-04 Impact factor: 5.315
Authors: Cağdaş Unlü; Niels de Korte; Lidewine Daniels; Esther C J Consten; Miguel A Cuesta; Michael F Gerhards; Anna A W van Geloven; Edwin S van der Zaag; Joost A B van der Hoeven; Rutger Klicks; Huib A Cense; Rudi M H Roumen; Quirijn A J Eijsbouts; Johan F Lange; Paul Fockens; Corianne A J M de Borgie; Wilem A Bemelman; Johannes B Reitsma; Hein B A C Stockmann; Bart C Vrouenraets; Marja A Boermeester Journal: BMC Surg Date: 2010-07-20 Impact factor: 2.102