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Published on: December 8, 2014
Review article: Management of diverticulitis
M M Szojda1, M A Cuesta, C M Mulder
1Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands.
Alimentary Pharmacology & Therapeutics
|January 8, 2008
Summary
Diverticular disease management focuses on medical treatment for uncomplicated cases. Complicated diverticulitis requires antibiotics or CT-guided drainage, with surgery reserved for specific complications like peritonitis or fistulas.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Internal Medicine
Background:
- The incidence of sigmoid diverticular disease and its complications is rising globally.
- Understanding risk factors and management strategies is crucial for patient outcomes.
Purpose of the Study:
- To review current literature on the diagnosis, management, and outcomes of diverticular disease.
- To identify risk groups and emerging treatment considerations for diverticulitis.
Main Methods:
- Comprehensive review of existing scientific literature on diverticular disease.
- Analysis of diagnostic modalities and treatment protocols.
Main Results:
- Diverticulitis affects 15% of patients, with 5% experiencing complications or bleeding.
- Computerized tomography (CT) is key for diagnosis; colonoscopy excludes malignancy.
- Risk factors for complicated disease include NSAID use, steroids, diabetes, and immune compromise.
Conclusions:
- Uncomplicated diverticulitis is managed medically.
- Complicated cases with small abscesses are treated with antibiotics; larger ones require CT-guided drainage.
- Surgery is reserved for peritonitis, fistulas, or obstruction; elective surgery for recurrence prevention is limited to select high-risk groups.
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