Skip Navigation
Skip to contents

Ann Coloproctol : Annals of Coloproctology

OPEN ACCESS
SEARCH
Search

Search

Page Path
HOME > Search
9 "Colonic diverticulitis"
Filter
Filter
Article category
Keywords
Publication year
Authors
Original Articles
Right-sided acute diverticulitis in the West: experience at a university hospital in Argentina
René M. Palacios Huatuco, Diana A. Pantoja Pachajoa, Julian E. Liaño, Héctor A. Picón Molina, Rafael Palencia, Alejandro M. Doniquian, Matías Parodi
Ann Coloproctol. 2023;39(2):123-130.   Published online November 24, 2021
DOI: https://doi.org/10.3393/ac.2021.00402.0057
  • 4,352 View
  • 142 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
Purpose
In the West, diverticular disease is located mainly in the left colon. However, it can also present in the right colon, with an incidence of 1% to 2% in Caucasians. The purpose of this study was to describe our experience in right-sided acute diverticulitis (RD).
Methods
In this retrospective study, 410 patients with acute diverticulitis treated from 2013 to 2020 were included in a university hospital in Córdoba, Argentina. Colonic diverticulitis was stratified into 2 groups; RD and left-sided acute diverticulitis. Demographic and clinical variables, laboratory and imaging findings, type of treatment, follow-up, and recurrence were analyzed.
Results
Sixteen patients (3.9%) with RD were identified; 62.5% were male and the mean age was 40.7±11.7 years. A total of 81.3% were Caucasian and 18.7% Native American. Significant differences were found between both groups of diverticulitis; patients with RD were younger (P=0.001), with lower BMI (P=0.01), comorbidity rate (P=0.01), Charlson comorbidity index (P=0.02), hospital stay (P=0.01), severity according to the Hinchey classification (P=0.001) and had a lower recurrence rate (P=0.001). There were no significant differences in sex (P=0.95), duration of pain until admission (P=0.05), laboratory findings (P=0.23) and treatment (P=0.34).
Conclusion
Conservative treatment predominated in RD, with a lower rate of complications and recurrences, providing data that support conservative therapy as initial treatment in RD in our environment.

Citations

Citations to this article as recorded by  
  • Comparison of surgical management and outcomes of acute right colic and sigmoid diverticulitis: a French national retrospective cohort study
    E. Karam, C. Sabbagh, L. Beyer-Bergeot, P. Zerbib, V. Bridoux, G. Manceau, Y. Panis, E. Buscail, A. Venara, I. Khaoudy, M. Gaillard, M. Viennet, A. Thobie, B. Menahem, C. Eveno, C. Bonnel, J.-Y. Mabrut, B. Badic, C. Godet, Y. Eid, E. Duchalais, Z. Lakkis,
    Techniques in Coloproctology.2024;[Epub]     CrossRef
Clinical Features and Factors Associated With Surgical Treatment in Patients With Complicated Colonic Diverticulitis
Pill Sun Paik, Jung-A Yun
Ann Coloproctol. 2017;33(5):178-183.   Published online October 31, 2017
DOI: https://doi.org/10.3393/ac.2017.33.5.178
  • 4,156 View
  • 69 Download
  • 6 Web of Science
  • 6 Citations
AbstractAbstract PDFSupplementary Material
Purpose

Colonic diverticulitis is uncommon in Korea, but the incidence is rapidly increasing nowadays. The clinical features and the factors associated with complications of diverticulitis are important for properly treating the disease.

Methods

A retrospective review of the medical records of 225 patients that were prospectively collected between October 2007 and September 2016 was conducted.

Results

Diverticulitis was detected mainly in men and women aged 30 to 50 years. Diverticulitis more frequently affected the right colon (n = 194, 86.2%), but age was higher in case of left colonic involvement (42 years vs. 57 years, P < 0.001). Percentages of comorbidities (65.6% vs. 23.8%, P < 0.001), complications (65.6% vs. 6.2%, P < 0.001), and surgical treatment (50.0% vs. 4.1%, P < 0.001) were significantly higher in patients with left colonic diverticulitis. In the multivariate analysis, a risk factor for complicated diverticulitis was left colonic involvement (P < 0.001; relative risk [RR], 47.108; 95% confidence interval [CI], 12.651–175.413). In complicated diverticulitis, age over 50 was the only significant risk factor for surgical treatment (P = 0.024; RR, 19.350; 95% CI, 1.474–254.023).

Conclusion

In patients over 50 years of age with left colonic diverticulitis, a preventive colectomy should be reconsidered as one of the options for treatment.

Citations

Citations to this article as recorded by  
  • Platelet to lymphocyte ratio is a risk factor for failure of non-operative treatment of colonic diverticulitis
    Jong Ho Kim, Sang Hyup Han, Jin-Won Lee, Haesung Kim, Jeonghee Han
    Scientific Reports.2023;[Epub]     CrossRef
  • Diagnosis and management of acute colonic diverticulitis: results of a survey among Korean gastroenterologists
    Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Shin Hee Lee, Myung-Won You, Seong-Eun Kim
    The Korean Journal of Internal Medicine.2023; 38(5): 672.     CrossRef
  • Management and long-term outcomes of acute right colonic diverticulitis and risk factors of recurrence
    Zhilong Ma, Weiwei Liu, Jia Zhou, Le Yao, Wangcheng Xie, Mingqi Su, Jin Yang, Jun Shao, Ji Chen
    BMC Surgery.2022;[Epub]     CrossRef
  • Predictive factors for conservative treatment failure of right colonic diverticulitis
    Youn Young Park, Soomin Nam, Jeong Hee Han, Jaeim Lee, Chinock Cheong
    Annals of Surgical Treatment and Research.2021; 100(6): 347.     CrossRef
  • Laparoscopic diverticulectomy versus non-operative treatment for uncomplicated right colonic diverticulitis
    Le Huy Luu, Nguyen Lam Vuong, Vo Thi Hong Yen, Do Thi Thu Phuong, Bui Khac Vu, Nguyen Viet Thanh, Nguyen Thien Khanh, Nguyen Van Hai
    Surgical Endoscopy.2020; 34(5): 2019.     CrossRef
  • Meta‐analysis of the demographic and prognostic significance of right‐sided versus left‐sided acute diverticulitis
    S. Hajibandeh, S. Hajibandeh, N. J. Smart, A. Maw
    Colorectal Disease.2020; 22(12): 1908.     CrossRef
Management of Colonic Diverticulitis Tailored to Location and Severity: Comparison of the Right and the Left Colon
Byeoung Hoon Chung, Gi Won Ha, Min Ro Lee, Jong Hun Kim
Ann Coloproctol. 2016;32(6):228-233.   Published online December 31, 2016
DOI: https://doi.org/10.3393/ac.2016.32.6.228
  • 4,397 View
  • 95 Download
  • 22 Web of Science
  • 22 Citations
AbstractAbstract PDF
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.

Citations

Citations to this article as recorded by  
  • Right‐sided acute diverticulitis in a North African country: Presentation and management in one surgical center
    Laila Jedidi, Aymen Mabrouk, Hela Ghali, Anis Ben Dhaou, Senda Ben Lahouel, Sami Daldoul, Houyem Said Latiri, Mounir Ben Moussa
    World Journal of Surgery.2024; 48(6): 1509.     CrossRef
  • Current diagnosis and management of acute colonic diverticulitis: What you need to know
    Lisa M. Kodadek, Kimberly A. Davis
    Journal of Trauma and Acute Care Surgery.2024; 97(1): 1.     CrossRef
  • Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines
    Federico Coccolini, Massimo Sartelli, Robert Sawyer, Kemal Rasa, Bruno Viaggi, Fikri Abu-Zidan, Kjetil Soreide, Timothy Hardcastle, Deepak Gupta, Cino Bendinelli, Marco Ceresoli, Vishal G. Shelat, Richard ten Broek, Gian Luca Baiocchi, Ernest E. Moore, Ib
    World Journal of Emergency Surgery.2023;[Epub]     CrossRef
  • Diagnosis and management of acute colonic diverticulitis: results of a survey among Korean gastroenterologists
    Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Shin Hee Lee, Myung-Won You, Seong-Eun Kim
    The Korean Journal of Internal Medicine.2023; 38(5): 672.     CrossRef
  • Right-sided diverticulitis in a Western population
    Adi Rov, Anat Ben-Ari, Eyal Barlev, David Pelcman, Sergio Susmalian, Haim Paran
    International Journal of Colorectal Disease.2022; 37(6): 1251.     CrossRef
  • Emergency surgery comparison of right versus left acute colonic diverticulitis: A 10-year outcome analysis
    JS Tsang, Chi Chung Foo, Jeremy Yip, Hok Kwok Choi, Wai Lun Law, Oswens Siu Hung Lo
    The Surgeon.2021; 19(3): 150.     CrossRef
  • Elective surgical management of diverticulitis
    Jordan M. Rook, Jill Q. Dworsky, Thomas Curran, Sudeep Banerjee, Mary R. Kwaan
    Current Problems in Surgery.2021; 58(5): 100876.     CrossRef
  • Special Situations in the Management of Diverticular Disease
    Elizabeth H. Wood, Michael M. Sigman, Dana M. Hayden
    Clinics in Colon and Rectal Surgery.2021; 34(02): 121.     CrossRef
  • Routine colonoscopy may be needed for uncomplicated acute right colonic diverticulitis
    Kil-yong Lee, Jaeim Lee, Youn Young Park, Seong Taek Oh
    BMC Gastroenterology.2021;[Epub]     CrossRef
  • WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections
    Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Boyko Atanasov, Goran Augustin, Miklosh Bala, Oussama Baraket, Suman Baral, Walter L. Biffl, Marja
    World Journal of Emergency Surgery.2021;[Epub]     CrossRef
  • Right sided diverticulitis in western countries: A review
    Angelo Gabriele Epifani, Diletta Cassini, Roberto Cirocchi, Caterina Accardo, Francesca Di Candido, Massimiliano Ardu, Gianandrea Baldazzi
    World Journal of Gastrointestinal Surgery.2021; 13(12): 1721.     CrossRef
  • Difference in Clinical Features between Right- and Left-Sided Acute Colonic Diverticulitis
    Kil-yong Lee, Jaeim Lee, Youn Young Park, Younglim Kim, Seong Taek Oh
    Scientific Reports.2020;[Epub]     CrossRef
  • 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting
    Massimo Sartelli, Dieter G. Weber, Yoram Kluger, Luca Ansaloni, Federico Coccolini, Fikri Abu-Zidan, Goran Augustin, Offir Ben-Ishay, Walter L. Biffl, Konstantinos Bouliaris, Rodolfo Catena, Marco Ceresoli, Osvaldo Chiara, Massimo Chiarugi, Raul Coimbra,
    World Journal of Emergency Surgery.2020;[Epub]     CrossRef
  • Clinical Characteristics of Right Colonic Diverticulitis: A Comparison of Ileocecal Diverticulitis and Hepatic Flexure Diverticulitis
    Yoshihisa Fujita, Fumihiko Ishikawa, Shigeyuki Kamata
    Nippon Daicho Komonbyo Gakkai Zasshi.2020; 73(6): 244.     CrossRef
  • Meta‐analysis of the demographic and prognostic significance of right‐sided versus left‐sided acute diverticulitis
    S. Hajibandeh, S. Hajibandeh, N. J. Smart, A. Maw
    Colorectal Disease.2020; 22(12): 1908.     CrossRef
  • Long-term outcome and management of right colonic diverticulitis in western countries: Multicentric Retrospective Study
    L. Courtot, V. Bridoux, Z. Lakkis, G. Piessen, G. Manceau, A. Mulliri, G. Meurette, A. Bouayed, A. Vénara, B. Blanc, N. Tabchouri, E. Salamé, M. Ouaïssi
    Journal of Visceral Surgery.2019; 156(4): 296.     CrossRef
  • Résultats à long terme et prise en charge des diverticulites du colon droit dans les pays occidentaux : étude rétrospective multicentrique
    L. Courtot, V. Bridoux, Z. Lakkis, G. Piessen, G. Manceau, A. Mulliri, G. Meurette, A. Bouayed, A. Vénara, B. Blanc, N. Tabchouri, E. Salamé, M. Ouaïssi
    Journal de Chirurgie Viscérale.2019; 156(4): 322.     CrossRef
  • Prospective randomized clinical trial of uncomplicated right-sided colonic diverticulitis: antibiotics versus no antibiotics
    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
    International Journal of Colorectal Disease.2019; 34(8): 1413.     CrossRef
  • Predictive Factors Affecting the Clinical Course of Patients With Diverticulitis: Who Needs Hospital Management?
    Taeyoung Yoo, Keun Ho Yang, Jungbin Kim, Inseok Park, Hyunjin Cho, Geumhee Gwak, Byung Noe Bae, Ki Hwan Kim
    Annals of Coloproctology.2018; 34(1): 23.     CrossRef
  • Perforated diverticulitis: is the right and left difference present here too?
    Nicholas Yock Teck Soh, Nan Zun Teo, Carrie Jen Hsi Tan, Shivani Rajaraman, Marianne Tsang, Calvin Jian Ming Ong, Ramesh Wijaya
    International Journal of Colorectal Disease.2018; 33(5): 525.     CrossRef
  • Clinical Features and Factors Associated With Surgical Treatment in Patients With Complicated Colonic Diverticulitis
    Pill Sun Paik, Jung-A Yun
    Annals of Coloproctology.2017; 33(5): 178.     CrossRef
  • What is the Difference Between Right- and Left-Sided Colonic Diverticulitis?
    Chang-Nam Kim
    Annals of Coloproctology.2016; 32(6): 206.     CrossRef
Short-term Intravenous Antibiotic Treatment in Uncomplicated Diverticulitis Does Not Increase the Risk of Recurrence Compared to Long-term Treatment
Cosimo Riccardo Scarpa, Nicolas Christian Buchs, Antoine Poncet, Béatrice Konrad-Mugnier, Pascal Gervaz, Philippe Morel, Frédéric Ris
Ann Coloproctol. 2015;31(2):52-56.   Published online April 30, 2015
DOI: https://doi.org/10.3393/ac.2015.31.2.52
  • 6,261 View
  • 52 Download
  • 13 Web of Science
  • 12 Citations
AbstractAbstract PDF
Purpose

This study included all patients treated at the University Hospital of Geneva for a first episode of uncomplicated diverticulitis. Risks of recurrence and treatment failure were evaluated by comparing the results between short-course and long-course intravenous (IV) antibiotic therapy groups.

Methods

The records of all patients hospitalized at our facility from January 2007 to February 2012 for a first episode of uncomplicated diverticulitis (Hinchey Ia), as confirmed by computed tomography, were prospectively collected. We published an auxiliary analysis from this registered study at Clinicaltrials.gov (identifier number: NCT01015378). Two groups of patients were considered: one received a short-course IV antibiotic arm (ceftriaxone and metronidazole) for up to 5 days (followed by 5 days of oral antibiotics); the other received a long-course IV arm between days 5 and 10. The primary outcome was the recurrence-free survival time.

Results

Follow-up was completed for 256 patients-50% men and 50% women, with a median age of 56 years (range, 24-85 years). The average follow-up was 50 months (range, 19-89 months). Of the 256 patients included in the study, 46 patients received a short-course IV antibiotic treatment and 210 received a long-course treatment. The recurrence-free survivals were very similar between the two groups, which was supported by a log rank test (P = 0.772). Four treatment failures, all in the long-course IV antibiotic treatment group, occurred.

Conclusion

Treatment of diverticulitis with a short IV antibiotic treatment is possible and does not modify the recurrence rate in patients with uncomplicated diverticulitis.

Citations

Citations to this article as recorded by  
  • Italian guidelines for the diagnosis and management of colonic diverticulosis and diverticular disease
    Marilia Carabotti, Costantino Sgamato, Antonio Amato, Benedetta Beltrame, Gian Andrea Binda, Bastianello Germanà, Gioacchino Leandro, Luigi Pasquale, Sergio Peralta, Maria Teresa Viggiani, Carola Severi, Bruno Annibale, Rosario Cuomo
    Digestive and Liver Disease.2024;[Epub]     CrossRef
  • Konservative Therapie der Divertikulitis
    Stephan K. Böhm
    coloproctology.2023; 45(3): 163.     CrossRef
  • Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis
    Ethan M. Balk, Gaelen P. Adam, Monika Reddy Bhuma, Kristin J. Konnyu, Ian J. Saldanha, Michael D. Beland, Nishit Shah
    Annals of Internal Medicine.2022; 175(3): 379.     CrossRef
  • Diagnosis and Management of Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians
    Amir Qaseem, Itziar Etxeandia-Ikobaltzeta, Jennifer S. Lin, Nick Fitterman, Tatyana Shamliyan, Timothy J. Wilt
    Annals of Internal Medicine.2022; 175(3): 399.     CrossRef
  • S3-Leitlinie Divertikelkrankheit/Divertikulitis – Gemeinsame Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV)
    Ludger Leifeld, Christoph-Thomas Germer, Stephan Böhm, Franz Ludwig Dumoulin, Thomas Frieling, Martin Kreis, Alexander Meining, Joachim Labenz, Johan Friso Lock, Jörg-Peter Ritz, Andreas Schreyer, Wolfgang Kruis
    Zeitschrift für Gastroenterologie.2022; 60(04): 613.     CrossRef
  • Recurrence of Uncomplicated Diverticulitis: A Meta-Analysis
    Guhyun Kang, Soomin Son, Young-Min Shin, Jung-Soo Pyo
    Medicina.2022; 58(6): 758.     CrossRef
  • German guideline diverticular disease/diverticulitis
    Wolfgang Kruis, Christoph‐Thomas Germer, Stephan Böhm, Franz Ludwig Dumoulin, Thomas Frieling, Jochen Hampe, Jutta Keller, Martin E. Kreis, Alexander Meining, Joachim Labenz, Johann F. Lock, Jörg Peter Ritz, Andreas G. Schreyer, Ludger Leifeld
    United European Gastroenterology Journal.2022; 10(9): 940.     CrossRef
  • Treatment with Ceftriaxone in Complicated Diverticulitis Increases the Incidence of Intra-Abdominal Enterococcus faecium Detection
    Julius Pochhammer, Axel Kramer, Matthias Orth, Michael Schäffer, Jan Henrik Beckmann
    Surgical Infections.2021; 22(5): 543.     CrossRef
  • Risk factors for recurrence after acute colonic diverticulitis: a systematic review
    Line Hupfeld, Jakob Burcharth, Hans-Christian Pommergaard, Jacob Rosenberg
    International Journal of Colorectal Disease.2017; 32(5): 611.     CrossRef
  • Acute colonic diverticulitis: an update on clinical classification and management with MDCT correlation
    Maxime Barat, Anthony Dohan, Karine Pautrat, Mourad Boudiaf, Raphael Dautry, Youcef Guerrache, Marc Pocard, Christine Hoeffel, Clarisse Eveno, Philippe Soyer
    Abdominal Radiology.2016; 41(9): 1842.     CrossRef
  • The Wind of Change: Uncomplicated Diverticulitis
    Hungdai Kim
    Annals of Coloproctology.2015; 31(2): 43.     CrossRef
  • Intermittent bacteremia detected in an asymptomatic apheresis platelet donor with repeat positive culture for Escherichia coli: a case report
    Sandra Ramirez‐Arcos, Ted Alport, Mindy Goldman
    Transfusion.2015; 55(11): 2606.     CrossRef
Safety of Nonoperative Management After Acute Diverticulitis
Javier Suarez Alecha, Sonia Amoza Pais, Xavi Batlle Marin, Begoña Oronoz Martinez, Enrique Balen Ribera, Concepción Yarnoz Irazabal
Ann Coloproctol. 2014;30(5):216-221.   Published online October 28, 2014
DOI: https://doi.org/10.3393/ac.2014.30.5.216
  • 3,535 View
  • 57 Download
  • 8 Web of Science
  • 8 Citations
AbstractAbstract PDF
Purpose

The role of surgery in the management of diverticular disease after an episode of acute diverticulitis (AD) managed in a conservative form is evolving. Age, number of episodes of AD, type of episode, and symptoms after the episodes are factors related to the need for elective surgery. The aim of this study is to evaluate the safety of conservative management and the risk factors for emergency surgery after a first episode of AD managed without surgery.

Methods

We retrospectively evaluated 405 patients diagnosed as having had a first episode of AD. Sixty-nine patients underwent emergency surgery on the first admission, and 69 patients had an elective operation in the follow-up (group A). The remaining 267 patients were managed initially without surgery (group B). Thirteen of these 267 patients needed a further urgent surgical procedure. Factors involved in the decision of elective surgery and the probability of emergency surgery after the first episode of AD managed without surgery were evaluated in relation to demographic factors, risk factors, presence of recurrences, and type of the first episode.

Results

Patients, mean age was 62.7 years, 71 were aged less than 51, and 151 were males. The mean follow-up for patients with nonoperative management was 91.2 months. An elective operation was performed in 69 patients. Compared to patients in group B, those in group A more frequently had a first episode of complicated acute diverticulitis (CAD) (37.1% vs. 16.4%; P = 0.000) and were more likely to be smokers (46.3% vs. 19.3%; P = 0.000) and to suffer more than one episode of AD (42% vs. 26.9%; P = 0.027). Nonoperative management was chosen for 267 patients, but 13 patients needed an emergency operation later. In the multivariate analysis, we found a significant relation between the presence of CAD in the first episode and the need for emergency surgery. There were no differences in surgical mortality between the patients in the two groups, but patients treated with elective surgery had a higher rate of stoma than patients treated non-operatively (7.2% vs. 1.4%; P = 0.028); this difference was not observed in the subgroup of patients with CAD (15.3% vs. 6.8%; P = 0.458).

Conclusion

After an episode of AD, nonoperative management is safe because fewer than 5% of patients will need an emergent procedure in a subsequent attack of AD. A first episode of CAD is the only risk factor for emergency surgery in patients managed conservatively.

Citations

Citations to this article as recorded by  
  • Elective surgical versus conservative management of complicated diverticulitis: A systematic review and meta‐analysis
    Marcus Yeow, Nicholas Syn, Choon Seng Chong
    Journal of Digestive Diseases.2022; 23(2): 91.     CrossRef
  • Surgical approach for right‐sided colonic diverticular bleeding: A single‐center review of 43 consecutive cases
    Hitoshi Kameyama, Toshiyuki Yamazaki, Akira Iwaya, Hiroaki Uehara, Shiori Utsumi, Motoharu Hirai, Masaru Komatsu, Akira Kubota, Tomohiro Katada, Kazuaki Kobayashi, Daisuke Sato, Naoyuki Yokoyama, Shirou Kuwabara, Tetsuya Otani
    Asian Journal of Endoscopic Surgery.2021; 14(4): 717.     CrossRef
  • Nonoperative Treatment of Diverticulitis
    Matthew Symer, Heather L. Yeo
    Advances in Surgery.2021; 55: 49.     CrossRef
  • Do Patients Mandate Resection After a First Episode of Acute Diverticulitis of the Colon with a Complication?
    Ryan Francis Bendl, Roberto Bergamaschi
    Advances in Surgery.2017; 51(1): 179.     CrossRef
  • 20-Year Trends in the Management of Diverticulitis Across New York State: an Analysis of 265,724 Patients
    Ryan Lamm, Steven N. Mathews, Jie Yang, Lijuan Kang, Dana Telem, Aurora D. Pryor, Mark Talamini, Jill Genua
    Journal of Gastrointestinal Surgery.2017; 21(1): 78.     CrossRef
  • Medically Treated Diverticular Abscess Associated With High Risk of Recurrence and Disease Complications
    Bikash Devaraj, Wendy Liu, James Tatum, Kyle Cologne, Andreas M. Kaiser
    Diseases of the Colon & Rectum.2016; 59(3): 208.     CrossRef
  • Nonoperative treatment of acute appendicitis in children: A feasibility study
    Joseph Hartwich, Francois I. Luks, Debra Watson-Smith, Arlet G. Kurkchubasche, Christopher S. Muratore, Hale E. Wills, Thomas F. Tracy
    Journal of Pediatric Surgery.2016; 51(1): 111.     CrossRef
  • Nonoperative Management of Acute Complicated Diverticulitis
    Byung Chun Kim
    Annals of Coloproctology.2014; 30(5): 206.     CrossRef
Case Report
A Case of Colovesical Fistula Induced by Sigmoid Diverticulitis
Hwa-Yeon Yang, Woo-Young Sun, Taek-Gu Lee, Sang-Jeon Lee
J Korean Soc Coloproctol. 2011;27(2):94-98.   Published online April 30, 2011
DOI: https://doi.org/10.3393/jksc.2011.27.2.94
  • 6,628 View
  • 51 Download
  • 15 Citations
AbstractAbstract PDF

Colonic diverticulosis has continuously increased, noticeably left-sided diseases, in Korea. A colovesical fistula is an uncommon complication of diverticulitis, and its most common cause is diverticular disease. Confirmation of its presence generally depends on clinical findings, such as pneumaturia and fecaluria. The primary aim of a diagnostic workup is not to observe the fistular tract itself but to find the etiology of the disease so that an appropriate therapy can be initiated. We present here the case of a 79-year-old man complaining of pneumaturia and fecaluria. On abdomen and pelvis CT, the patient was diagnosed as having a colovesical fistula due to sigmoid diverticulitis. After division of the adhesion between the sigmoid colon and the bladder, the defect of the bladder wall was repaired by simple closure. The colonic defect was treated with a segmental resection, including the rectosigmoid junction. The patient is doing well at 6 months after the operation and shows no evidence of recurrence of the fistula.

Citations

Citations to this article as recorded by  
  • Pre-existing Opioid Use Worsens Outcomes in Patients With Diverticulitis
    Amjad Shaikh, Ayham Khrais, Alexander Le, Alexander J Kaye, Sushil Ahlawat
    Cureus.2023;[Epub]     CrossRef
  • Early Urinary Catheter Removal After Colectomy for Colovesical Fistula is Not Associated With Increased Postoperative Complications
    Stevie-Jay Stapler, Sara M Colom, Dixy Rajkumar, Robert K Cleary
    The American Surgeon™.2023; 89(12): 6091.     CrossRef
  • Migration of a bladder diverticulum stone into the rectum revealing an advanced rectal process
    Meriem Boui, Badr Slioui, Ben Elhend Salah, Zakaria Zouaki, Mohamed El Biadi, Salah Bellasri, Nabil Hammoune, Mehdi Atmane, Abdelilah Mouhsine
    Radiology Case Reports.2023; 18(12): 4510.     CrossRef
  • Emphysematous cystitis as a potential marker of severe Crohn's disease
    S. M. Mahmudul Hasan, Baljinder S. Salh
    BMC Gastroenterology.2022;[Epub]     CrossRef
  • Colovesical fistula in a young adult due to sigmoid colon diverticulitis undetected in computed tomography: Case report and review of literature
    Francisco Marcos da Silva Barroso, Carolina Augusta Dorgam Maués, Gustavo Lopes de Castro, Renato da Silva Galvão, José Paulo Guedes Saint Clair, Laura Riberio Aref Kzam
    Annals of Medicine and Surgery.2021; 69: 102658.     CrossRef
  • A case report: Use of FT-IR analysis to improve Colovesical fistula diagnosis
    S. Rapi, A. Bonari, S. Dugheri, G. Cappelli, L. Trevisani, E. Milletti, N. Mucci, G. Arcangeli, A. Morettini, A. Fanelli
    Practical Laboratory Medicine.2021; 27: e00255.     CrossRef
  • Entero-vesical fistula revealed by recurrent urinary tract infection
    Youness Jabbour, Youssef Lamzaf, Tarik Karmouni, Khalid El Khader, Abdellatif Koutani, Ahmed Iben Attya Andaloussi
    Urology & Nephrology Open Access Journal.2018; 6(4): 127.     CrossRef
  • Complications of the diverticular disease - colocutaneous and colovesical fistula
    Zuzana Adamová, Radim Slováček, Dalibor Dvořák, Tomáš Bár, Rostislav Čureček, Petr Rohlík
    Medicína pro praxi.2017; 14(3): 147.     CrossRef
  • When a good call leads to a bad connection: colovesical fistula in colorectal cancer treated with bevacizumab
    Jeffrey Chen, Roger D. Smalligan, Suhasini Nadesan
    Hospital Practice.2016; 44(3): 120.     CrossRef
  • Laparoscopic surgery of benign entero-vesical or entero-vaginal fistulae
    Matthias Kraemer, David Kara
    International Journal of Colorectal Disease.2016; 31(1): 19.     CrossRef
  • Laparoscopic treatment of colovesical fistulas due to complicated colonic diverticular disease: a systematic review
    R. Cirocchi, G. Cochetti, J. Randolph, C. Listorti, E. Castellani, C. Renzi, E. Mearini, A. Fingerhut
    Techniques in Coloproctology.2014; 18(10): 873.     CrossRef
  • A Rare Case of Nephrocolic Fistula Resulting from Radio Frequency Ablation (RFA) of Renal Cell Carcinoma
    Bhavesh J. Patel, Arvind K. Mathur, Nishant Puri, Christian S. Jackson
    ACG Case Reports Journal.2014; 1(2): 93.     CrossRef
  • Bladder diverticulitis on PET/CT
    Brian Wosnitzer
    Radiology Case Reports.2012; 7(2): 673.     CrossRef
  • Extra-abdominal lumbar abscesses caused by retroperitoneal gastrointestinal perforations through the lumbar triangle of Petit: report of two cases diagnosed by CT
    Bruno Coulier, Monica Gogoase, Adrien Ramboux, Frederic Pierard
    Abdominal Imaging.2012; 37(6): 1122.     CrossRef
  • Colouterine Fistula Caused by Diverticulitis of the Sigmoid Colon
    Pyong Wha Choi
    Journal of the Korean Society of Coloproctology.2012; 28(6): 321.     CrossRef
Original Articles
Treatment of Right Colonic Diverticulitis: The Role of Nonoperative Treatment
Ma Ru Kim, Bong-Hyeon Kye, Hyung Jin Kim, Hyeon-Min Cho, Seong Taek Oh, Jun-Gi Kim
J Korean Soc Coloproctol. 2010;26(6):402-406.   Published online December 31, 2010
DOI: https://doi.org/10.3393/jksc.2010.26.6.402
  • 3,517 View
  • 39 Download
  • 24 Citations
AbstractAbstract PDF
Purpose

The purpose of this study is to evaluate the value of nonoperative treatment for right-sided colonic diverticulitis.

Methods

One hundred fifty-eight patients with right-sided colonic diverticulitis were evaluated. Clinical history, physical and radiologic findings, and treatments were reviewed retrospectively. Also, additional episodes and treatment modalities were checked.

Results

Our patients were classified according to treatment modality; 135 patients (85.4%) underwent conservative treatment, including antibiotics and bowel rest, and 23 patients (14.6%) underwent surgery. The mean follow-up length was 37.3 months, and 17 patients (17.5%) underwent recurrent right-sided colonic diverticulitis. Based on treatment modality, including surgery and antibiotics, no significant differences in the clinical features and the recurrence rates were noted between the two groups.

Conclusion

Conservative management with bowel rest and antibiotics could be considered as a safe and effective option for treating right-sided colonic diverticulitis. This treatment option for right-sided colonic diverticulitis, even if the disease is complicated, may be the treatment of choice.

Citations

Citations to this article as recorded by  
  • Comparison of surgical management and outcomes of acute right colic and sigmoid diverticulitis: a French national retrospective cohort study
    E. Karam, C. Sabbagh, L. Beyer-Bergeot, P. Zerbib, V. Bridoux, G. Manceau, Y. Panis, E. Buscail, A. Venara, I. Khaoudy, M. Gaillard, M. Viennet, A. Thobie, B. Menahem, C. Eveno, C. Bonnel, J.-Y. Mabrut, B. Badic, C. Godet, Y. Eid, E. Duchalais, Z. Lakkis,
    Techniques in Coloproctology.2024;[Epub]     CrossRef
  • Right-sided diverticulitis in a Western population
    Adi Rov, Anat Ben-Ari, Eyal Barlev, David Pelcman, Sergio Susmalian, Haim Paran
    International Journal of Colorectal Disease.2022; 37(6): 1251.     CrossRef
  • Investigation of the clinical features and recurrence patterns of acute right-sided colonic diverticulitis: A retrospective cohort study
    Moon Young Oh, Rumi Shin, Seung Chul Heo, Han-Ki Lim, Min Jung Kim, Ji Won Park, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park
    Annals of Medicine and Surgery.2022; 81: 104431.     CrossRef
  • Emergency surgery comparison of right versus left acute colonic diverticulitis: A 10-year outcome analysis
    JS Tsang, Chi Chung Foo, Jeremy Yip, Hok Kwok Choi, Wai Lun Law, Oswens Siu Hung Lo
    The Surgeon.2021; 19(3): 150.     CrossRef
  • Conservative treatment of uncomplicated right-sided diverticulitis: a systematic review and meta-analysis
    Jun Ho Lee, Byung Kyu Ahn, Kang Hong Lee
    International Journal of Colorectal Disease.2021; 36(8): 1791.     CrossRef
  • Conventional-Dose CT Versus 2-mSv CT for Right Colonic Diverticulitis as an Alternate Diagnosis of Appendicitis: Secondary Analysis of Large Pragmatic Randomized Trial Data
    Hae Young Kim, Seungjae Lee, Dong Hwan Kim, Yousun Ko, Ji Hoon Park, Ara Ko, Seok Min Jeong, Sung Bin Park, Kyoung Ho Lee
    American Journal of Roentgenology.2021; 217(5): 1113.     CrossRef
  • Laparoscopic diverticulectomy versus non-operative treatment for uncomplicated right colonic diverticulitis
    Le Huy Luu, Nguyen Lam Vuong, Vo Thi Hong Yen, Do Thi Thu Phuong, Bui Khac Vu, Nguyen Viet Thanh, Nguyen Thien Khanh, Nguyen Van Hai
    Surgical Endoscopy.2020; 34(5): 2019.     CrossRef
  • Diverticulitis aguda del ángulo hepático simulando un cuadro de colecistitis aguda
    M. Gonzalez-Urquijo, A. Baca-Arzaga, G. Lozano-Balderas
    Revista de Gastroenterología de México.2020; 85(4): 484.     CrossRef
  • Short‐ and Long‐Term Outcomes of Right‐Sided Diverticulitis: Over 15 Years of North American Experience
    Jesse Zuckerman, Richard Garfinkle, Carol‐Ann Vasilevksy, Gabriela Ghitulescu, Julio Faria, Nancy Morin, Marylise Boutros
    World Journal of Surgery.2020; 44(6): 1994.     CrossRef
  • Acute diverticulitis of the hepatic flexure mimicking acute cholecystitis
    M. Gonzalez-Urquijo, A. Baca-Arzaga, G. Lozano-Balderas
    Revista de Gastroenterología de México (English Edition).2020; 85(4): 484.     CrossRef
  • Laparoscopic repair of perforated cecal diverticulitis
    K. Spacil, J. Meyer, M. Stehr, M. Schäfer
    Journal of Pediatric Surgery Case Reports.2019; 42: 17.     CrossRef
  • Long-term outcome and management of right colonic diverticulitis in western countries: Multicentric Retrospective Study
    L. Courtot, V. Bridoux, Z. Lakkis, G. Piessen, G. Manceau, A. Mulliri, G. Meurette, A. Bouayed, A. Vénara, B. Blanc, N. Tabchouri, E. Salamé, M. Ouaïssi
    Journal of Visceral Surgery.2019; 156(4): 296.     CrossRef
  • Résultats à long terme et prise en charge des diverticulites du colon droit dans les pays occidentaux : étude rétrospective multicentrique
    L. Courtot, V. Bridoux, Z. Lakkis, G. Piessen, G. Manceau, A. Mulliri, G. Meurette, A. Bouayed, A. Vénara, B. Blanc, N. Tabchouri, E. Salamé, M. Ouaïssi
    Journal de Chirurgie Viscérale.2019; 156(4): 322.     CrossRef
  • A Rare Case of Acute Right-Sided Colonic Diverticulitis Presenting as Pancreatitis
    Maria de Lourdes Ladino Sturchler, Evan A. Rusoja, Arun Nagdev, Barry C. Simon
    The Journal of Emergency Medicine.2018; 54(4): e77.     CrossRef
  • Efficacy of conservative management in patients with right colonic diverticulitis
    Gi Won Ha, Min Ro Lee, Jong Hun Kim
    ANZ Journal of Surgery.2017; 87(6): 467.     CrossRef
  • Intraoperative diagnosis of solitary cecal diverticulum not requiring surgery: is appendectomy indicated?
    Renol M. Koshy, Abdelrahman Abusabeib, Saif Al-Mudares, Mohamed Khairat, Adriana Toro, Isidoro Di Carlo
    World Journal of Emergency Surgery.2016;[Epub]     CrossRef
  • Diagnosis and Management of Right Colonic Diverticular Disease: A Review
    Francesco Ferrara, Jesús Bollo, Letizia V. Vanni, Eduardo M. Targarona
    Cirugía Española (English Edition).2016; 94(10): 553.     CrossRef
  • Diagnóstico y tratamiento de la enfermedad diverticular del colon derecho: revisión de conjunto
    Francesco Ferrara, Jesús Bollo, Letizia V Vanni, Eduardo M Targarona
    Cirugía Española.2016; 94(10): 553.     CrossRef
  • Diverticular Disease: Guidelines of the German Society for Gastroenterology, Digestive and Metabolic Diseases and the German Society for General and Visceral Surgery
    Wolfgang Kruis, Christoph-Thomas Germer, Ludger Leifeld
    Digestion.2014; 90(3): 190.     CrossRef
  • Non-operative treatment of right-sided colonic diverticulitis has good long-term outcome: a review of 226 patients
    Ker-Kan Tan, Jiayi Wong, Richard Sim
    International Journal of Colorectal Disease.2013; 28(6): 849.     CrossRef
  • Visceral Obesity as a Risk Factor for Left-Sided Diverticulitis in Japan: A Multicenter Retrospective Study
    Eiji Yamada, Hidenori Ohkubo, Takuma Higurashi, Eiji Sakai, Hiroki Endo, Hirokazu Takahashi, Eri Uchida, Emi Tanida, Nobuyoshi Izumi, Akira Kanesaki, Yasuo Hata, Tetsuya Matsuura, Nobutaka Fujisawa, Kazuto Komatsu, Shin Maeda, Atsushi Nakajima
    Gut and Liver.2013; 7(5): 532.     CrossRef
  • Risk Factors for Severe Diverticulitis in Computed Tomography-Confirmed Acute Diverticulitis in Korea
    Nark-Soon Park, Yoon Tae Jeen, Hyuk Soon Choi, Eun Sun Kim, Young Jin Kim, Bora Keum, Yeon Seok Seo, Hoon Jai Chun, Hong Sik Lee, Soon Ho Um, Chang Duck Kim, Ho Sang Ryu
    Gut and Liver.2013; 7(4): 443.     CrossRef
  • The Clinical Factors for Predicting Severe Diverticulitis in Korea: A Comparison with Western Countries
    Sun Young Kim, Tae Hoon Oh, Ji Young Seo, Tae Joo Jeon, Dong Dae Seo, Won Chang Shin, Won Choong Choi, Myeong Ja Jeong
    Gut and Liver.2012; 6(1): 78.     CrossRef
  • Special Situations in the Management of Colonic Diverticular Disease
    Yoori Lee, Todd Francone
    Seminars in Colon and Rectal Surgery.2011; 22(3): 180.     CrossRef
Difference in Clinical Features between Appendicitis and Right-Sided Colonic Diverticulitis on Initial Diagnosis.
Lee, Eun Kyu , Kim, Hungdai , Son, Beong Ho , Han, Won Kon
J Korean Soc Coloproctol. 2005;21(4):201-206.
  • 927 View
  • 7 Download
AbstractAbstract PDF
PURPOSE
Most patients who are finally diagnosed as having cecal and right-sided colonic diverticulitis complain of pain in the right lower quadrant of the abdomen, many of them unfortunately undergo an emergency operation for presumed appendicitis. Our purpose was to differentiate the diagnosis of right-sided colonic diverticulitis from appendicitis in an emergency setting.
METHODS
We retrospectively reviewed the medical records of 450 patients between January 1997 and July 2003. Among them, 92 patients who had been diagnosed as having right-sided colonic diverticulitis were classified as Group I. In the remaining 358 patients with appendicitis, 268 patients with simple appendicitis were classified as Group II and 90 patients with perforated appendicitis were classified as Group III.
RESULTS
The sex ratios were similar among 3 groups. The mean age of Group I (36.5+/-10.1 years) was significantly different from that of Group II (30.7+/-14.8 years, P=0.002), but not from that of Group III (38.7+/-20.9). Incidences of fever/chill and nausea/vomiting were less common in Group I (P<0.05). The duration of prodromal symptoms in Group I (2.6 days) was longer than that of Group II (1.6 days, P=0.02), but was not significantly different from that of Group III (3.3 days, P=0.83). The mean WBC count was significantly smaller in Group I (10913.8/mm3) than in Group II (13238.3/mm3) and III (15589.3/mm3, P<0.001). The percentage of segment form in differential counts was smaller in Group I (73.6%) than in Group II (79.1%) and III (81.8%, P<0.001). The percentage of lymphocytes in differential counts was larger in Group I (17.7%) than in Group II (13.9%) and Group III (9.4%, P<0.001).
CONCLUSIONS
Among the patients who complain of pain in the right lower quadrant abdomen in an emergency setting, cecum and right-sided colonic diverticulitis must be considered in the following conditions to avoid unnecessary emergency operations, relatively younger patients (20~40 years), infrequent prodromal symptoms, absent rebound tenderness with a laterally deviated maximal tenderness point, and absent or mild leucocytosis with a relatively low fraction of segment forms associated with a higher fraction of lymphocytes in CBC.
Clinical Analysis of Right Colonic Diverticulitis That was Operated under the Impression of Acute Appendicitis.
Cho, Hyeoun Jun , Cho, Seung Yeon , Oh, Jae Hwan
J Korean Soc Coloproctol. 2000;16(1):18-24.
  • 1,262 View
  • 35 Download
AbstractAbstract PDF
PURPOSE
Because there are no significant differences of the clinical findings between the appendicitis and cecal diverticulitis, it is very difficult to make a correct diagnosis preoperatively and to choose a appropriate management intraoperatively. The purpose of this study is to investigate the clinical charateristics of right diveticulitis and to evaluate the appropriateness of surgical management.
METHODS
We reviewed 45 cases of right colonic diverticulitis which underwent emergency operation under the impression of acute appendicitis during 10 years from January 1988 to December 1997.
RESULTS
Of them, 38 cases were treated by diverticulectomy with appendectomy (Group I), and 7 cases were treated by resection (ileocecal resection or right hemicolectomy) (Group II). The male to female ratio was 4:1, and the mean age was 38.2 years. In Group I, all cases had a solitary inflamed cecal diverticulum. In group II, two cases had a solitary cecal diverticulitis, whereas five cases had multiple ones. Postoperative complications were found in 14 cases, but all of them were not significant. Postoperative Barium enema was performed in 22 cases of Group I, in two cases of Group II. In Group I, 8 cases had a residual diverticulum at postoperative Barium enema. In Group II, no residual diverticulum was shown. Follow-up study by Telephone was done at 16 cases, there were no symptomatic recurrences.
CONCLUSIONS
In conclusion, when right colonic diverticulitis is found at the time of operation, surgical management is a safe treatment with low morbidity and low recurrence rate. Diverticulectomy with appendectomy is a safe surgical procedure for the uncomplicated diverticulitis. If diverticulitis is complicating, multiple or undistinguishable with malignancy, resection (ileocecal resection, right hemicolectomy) should be considered as a primary surgical treatment. Postoperative colon study is helpful, due to high incidence of residual diverticulum.
  • FirstFirst
  • PrevPrev
  • Page of 1
  • Next Next
  • Last Last

Ann Coloproctol : Annals of Coloproctology Twitter Facebook
TOP