Diverticulitis of the Right Colon: Tips for Preoperative Diagnosis and Treatment Strategy

J Korean Soc Coloproctol

Park

et al. 2011

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PurposeThe goals of this study were to identify whether conservative treatment with antibiotics in right colonic diverticulitis (RCD) patients, our empirical method used until now, is adequate and to determine how the natural history of RCD is affected by conservative treatment.MethodsThis study was designed as a case-control study. Group I was comprised of 12 patients who were managed conservatively, and clinical data were retrospectively collected. In group II, a total of 49 patients, diagnosed by using diagnostic criteria for RCD and managed conservatively, were prospectively included.ResultsThe period of fasting was 2.7 days, and the hospital stay was 4.6 days in all patients. The intravenous and the oral antibiotic periods were 3.8 days and 9.8 days, respectively. There were no statistically significant differences in treatment results between the two groups except the duration of fasting and the hospitalization, and there were no complications under conservative treatment. Eight patients (13.1%) had recurrent diverticulitis during the follow-up period. The recurrence risk showed no significant difference between the groups. The RCD-free period after management was 60.1 months, and patients with recurrent RCD were treated by conservative treatment or laparoscopic surgery.ConclusionConservative treatment with antibiotics is the optimal treatment of choice for RCD and shows no increase in complications.

Section: Discussionsupporting

confidence: 92%

Is Conservative Treatment with Antibiotics the Correct Strategy for Management of Right Colonic Diverticulitis?: A Prospective Study

Kim

J Korean Soc Coloproctol

Park

et al. 2011

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“…Also, although the diagnostic rate has been low in the past, the use of universalized abdominal CT scans and improvements in diagnostic criteria have increased the diagnostic rate to 85.7% [1, 2, 8]. RCD is especially common among males (2-3.…”

Section: Epidemiology Of Rcdmentioning

confidence: 99%

“…Through a retrospective study, only 17 patients (18.9%) showed nausea, and 5 patients (5.6%) showed vomiting [2]. In a prospective study, only 1 out of 13 patients with RCD had nausea and vomiting; showing a significant difference from patients with appendicitis (P < 0.001) [1].…”

Section: Symptoms Of Rcdmentioning

confidence: 99%

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Right Colonic Diverticulitis

J Korean Soc Coloproctol

2010

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Although right colonic diverticultis (RCD) has been reported to be a rare disease in Western countries, RCD is a common diagnosis, with an incidence per 2.9-17 case of appendicitis, in Korea. Many Western studies have reported that it is difficult to differentiate the presenting symptoms of RCD from those of appendicitis before surgery because the signs and symptoms are similar. However, performing a computed tomography scan after the application of the diagnostic criteria for RCD has increased the preoperative RCD diagnostic rate. Treatment strategies have been difficult to define for this condition due to its low preoperative diagnosis rate. However, recent reports have shown that conservative medical treatment of uncomplicated RCD can be recommended and that such treatment is effective due to the benign and self-limited natural history of RCD. Therefore, in this review, we discuss the controversies surrounding RCD management.

“…The recurrence rate after conservative management for right colonic uncomplicated diverticulitis varies among studies (approximately 7.1-20.5 %) [7,9,10]. The causes of recurrence are not yet understood.…”

Section: Introductionmentioning

confidence: 96%

Risk factors for recurrence of right colonic uncomplicated diverticulitis after first attack

Park

Kim

et al. 2014

Int J Colorectal Dis