BACKGROUND: Surgical resection is typically recommended for patients with computed tomography (CT)-confirmed complicated diverticulitis. This study was designed to assess outcomes of patients with complicated diverticulitis managed nonoperatively. METHODS: A retrospective study covering 14 years evaluated patients with complicated diverticulitis diagnosed by CT scan. Patient outcomes, including recurrence and need for operations, were reviewed. RESULTS: Of 256 patients identified, 99 were managed nonoperatively. Forty-six of the 99 patients had a recurrent episode of diverticulitis. Of these 46 patients, 20 underwent a sigmoid colon resection, with only 1 patient requiring a colostomy for obstruction. None of these recurrences resulted in the need for emergency resection. CONCLUSIONS: Surgical treatment should play an important role in the management of patients with complicated diverticulitis because of the high risk of recurrence. However, nonoperative management may be appropriate in a select population if age or medical comorbidities preclude a safe operation since the need for emergency operation is unlikely.
BACKGROUND: Surgical resection is typically recommended for patients with computed tomography (CT)-confirmed complicated diverticulitis. This study was designed to assess outcomes of patients with complicated diverticulitis managed nonoperatively. METHODS: A retrospective study covering 14 years evaluated patients with complicated diverticulitis diagnosed by CT scan. Patient outcomes, including recurrence and need for operations, were reviewed. RESULTS: Of 256 patients identified, 99 were managed nonoperatively. Forty-six of the 99 patients had a recurrent episode of diverticulitis. Of these 46 patients, 20 underwent a sigmoid colon resection, with only 1 patient requiring a colostomy for obstruction. None of these recurrences resulted in the need for emergency resection. CONCLUSIONS: Surgical treatment should play an important role in the management of patients with complicated diverticulitis because of the high risk of recurrence. However, nonoperative management may be appropriate in a select population if age or medical comorbidities preclude a safe operation since the need for emergency operation is unlikely.
Authors: Kai Bachmann; Geeske Krause; Tamina Rawnaq; Lena Tomkotter; Yogesh Vashist; Shanly Shahmiri; Jakob R Izbicki; Maximilian Bockhorn Journal: World J Gastroenterol Date: 2011-12-28 Impact factor: 5.742
Authors: B J M van de Wall; W A Draaisma; E C J Consten; R T van der Kaaij; M J Wiezer; I A M J Broeders Journal: J Gastrointest Surg Date: 2012-12-14 Impact factor: 3.452
Authors: Adil E Bharucha; Gopanandan Parthasarathy; Ivo Ditah; J G Fletcher; Ofor Ewelukwa; Rajesh Pendlimari; Barbara P Yawn; L Joseph Melton; Cathy Schleck; Alan R Zinsmeister Journal: Am J Gastroenterol Date: 2015-09-29 Impact factor: 10.864