Emergency surgery for colonic diverticulitis: differences between right-sided and left-sided lesions

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Colorectal Surgery

Background:

• Right-sided colonic diverticulitis is uncommon in Western countries but prevalent in Asia.
• Often misdiagnosed as appendicitis, leading to surgery.
• This study investigates differences between right-sided and left-sided colonic diverticulitis.

Purpose of the Study:

• To compare the demographic, clinical, and outcome differences between right-sided and left-sided colonic diverticulitis requiring emergency surgery.
• To evaluate the impact of disease location on surgical outcomes and patient prognosis.

Main Methods:

• Retrospective analysis of 60 patients undergoing emergency surgery for colonic diverticulitis.
• Data collected included demographics, operation type, and surgical outcomes.
• Patients were categorized into right-sided (n=37) and left-sided (n=23) disease groups.

Main Results:

• Right-sided diverticulitis patients were younger (mean 41.9 years) with male predominance (78.4%).
• Left-sided diverticulitis patients were older (mean 74.2 years) with higher rates of generalized peritonitis (74%).
• Mortality was 0% for right-sided vs. 13% for left-sided; morbidity was 14.2% vs. 61%, respectively. Left-sided disease also had longer hospital stays.

Conclusions:

• Significant demographic and presentation disparities exist between right-sided and left-sided colonic diverticulitis.
• Emergency surgery for left-sided diverticulitis is associated with substantially higher mortality and morbidity rates.
• Understanding these differences is crucial for appropriate diagnosis and management of colonic diverticulitis.