Literature DB >> 28119866

Management of Colonic Diverticulitis Tailored to Location and Severity: Comparison of the Right and the Left Colon.

Byeoung Hoon Chung1, Gi Won Ha1, Min Ro Lee1, Jong Hun Kim1.   

Abstract

PURPOSE: This study assessed optimal management of colonic diverticulitis as functions of disease location and severity and factors associated with complicated diverticulitis.
METHODS: This retrospective review analyzed 202 patients diagnosed between 2007 and 2014 at Chonbuk National University Hospital, South Korea, with colonic diverticulitis by using abdominopelvic computed tomography. Diverticulitis location was determined, and disease severity was categorized using the modified Hinchey classification.
RESULTS: Patients included 108 males (53.5%) and 94 females (46.5%); of these, 167 patients (82.7%) were diagnosed with right-sided and 35 (17.3%) with left-sided colonic diverticulitis. Of the 167 patients with right-sided colonic diverticulitis, 12 (7.2%) had complicated and 155 (92.8%) had uncomplicated diverticulitis; of these, 157 patients (94.0%) were successfully managed conservatively. Of the 35 patients with left-sided colonic diverticulitis, 23 (65.7%) had complicated and 12 (34.3%) had uncomplicated diverticulitis; of these, 23 patients (65.7%) were managed surgically. Among patients with right-sided diverticulitis, those with complicated disease were significantly older (54.3 ± 12.7 years vs. 42.5 ± 13.4 years, P = 0.004) and more likely to be smokers (66.7% vs. 32.9%, P = 0.027) than those with uncomplicated disease. However, among patients with left-sided diverticulitis, those with complicated disease had significantly lower body mass index (BMI; 21.9 ± 4.7 kg/m2 vs. 25.8 ± 4.3 kg/m2, P = 0.021) than those with uncomplicated disease.
CONCLUSION: Conservative management may be effective in patients with right-sided diverticulitis and patients with uncomplicated left-sided colonic diverticulitis. Surgical management may be required for patients with complicated left-sided diverticulitis. Factors associated with complicated diverticulitis include older age, smoking and lower BMI.

Entities:  

Keywords:  Anti-bacterial agents/therapeutic use; Colonic diverticulitis; Computed tomography; Risk factors; Treatment outcome

Year:  2016        PMID: 28119866      PMCID: PMC5256252          DOI: 10.3393/ac.2016.32.6.228

Source DB:  PubMed          Journal:  Ann Coloproctol        ISSN: 2287-9714


  27 in total

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3.  Surgical approach to cecal diverticulitis.

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4.  The efficacy of nonoperative management of acute complicated diverticulitis.

Authors:  Sekhar Dharmarajan; Steven R Hunt; Elisa H Birnbaum; James W Fleshman; Matthew G Mutch
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5.  Usefulness of colonic motility study in identifying patients at risk for complicated diverticular disease.

Authors:  C Cortesini; D Pantalone
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6.  Non-operative treatment of right-sided colonic diverticulitis has good long-term outcome: a review of 226 patients.

Authors:  Ker-Kan Tan; Jiayi Wong; Richard Sim
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7.  The diagnostic criteria for right colonic diverticulitis: prospective evaluation of 100 patients.

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5.  What is the Difference Between Right- and Left-Sided Colonic Diverticulitis?

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Journal:  Ann Coloproctol       Date:  2016-12-31

6.  Predictive Factors Affecting the Clinical Course of Patients With Diverticulitis: Who Needs Hospital Management?

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Journal:  Ann Coloproctol       Date:  2018-02-28

Review 7.  2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting.

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10.  Clinical Features and Factors Associated With Surgical Treatment in Patients With Complicated Colonic Diverticulitis.

Authors:  Pill Sun Paik; Jung-A Yun
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