Management of right colonic uncomplicated diverticulitis: outpatient versus inpatient management

Initial conservative management may be the mainstay of therapy for uncomplicated right colonic diverticulitis. However, definitive treatment guidelines have not yet been established. In this study, we assessed the efficacy of outpatient management versus inpatient management for preventing recurrence of this condition.

Between 2007 and 2009, a total of 103 patients were consecutively enrolled at the first attack of uncomplicated right colonic diverticulitis. In this prospective observational study, 40 patients underwent an outpatient management regimen consisting of oral antibiotics (for 4 days), and 63 patients underwent an inpatient management regimen that included bowel rest and intravenous antibiotics (for 7-10 days). The treatment was selected by the patient. Failure to respond to therapy and the incidence of recurrence of this condition were assessed.

Both groups of patients were treated successfully, and their symptoms were relieved. The patients were followed up for a median time of 21 months. Of the 40 patients with short-term oral antibiotic therapy on an outpatient basis, disease recurrence was observed in 4 patients (10%). Of these four patients, one underwent surgery and the remaining three were treated nonoperatively. Of the 63 patients on inpatient management, recurrence was observed in 7 patients (11%). Of these seven patients, one underwent surgery and the remaining six were treated nonoperatively.

Outpatient management with short-term oral antibiotic therapy for the treatment of uncomplicated right colonic diverticulitis is as effective as inpatient management in regard to preventing disease recurrence.