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Management of Hinchey II diverticulitis
Soni Soumian1, Sudeep Thomas, Prasoon P Mohan
1Department of Surgery, Good Hope Hospital, Heart of England NHS, Foundation Trust, Rectory Road, Sutton Coldfield, Birmingham, B75 7RR, United Kingdom. sonisoumian@yahoo.com
World Journal of Gastroenterology
|December 17, 2008
Summary
Management of Hinchey type II diverticulitis, or colonic diverticular abscesses, often involves antibiotics and percutaneous guided drainage (PCD). Conservative treatment is effective for most cases, with surgery reserved for select patients.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
Background:
- Colonic diverticulosis can lead to severe complications like abscess formation (Hinchey type II).
- The optimal management strategy for Hinchey type II diverticulitis remains debated, with options including conservative care, percutaneous drainage, and surgery.
Purpose of the Study:
- To review the current literature on the management of Hinchey type II diverticulitis.
- To compare institutional data with published findings regarding diverticular abscess treatment.
Main Methods:
- A Medline-based literature search was conducted focusing on Hinchey type II diverticulitis management.
- Retrospective analysis of five-year institutional data on diverticular abscesses was performed for comparison.
Main Results:
- Conservative treatment with antibiotics is effective for the majority of patients.
- Percutaneous guided drainage (PCD) plays a role in managing large, accessible abscesses.
- Recurrence rates vary, and elective surgery is recommended for specific patient groups.
Conclusions:
- Antibiotics alone are sufficient for many Hinchey type II diverticulitis cases.
- Percutaneous guided drainage is a valuable option for larger abscesses.
- Careful patient selection is crucial for determining the need for elective surgery to minimize recurrence.
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