Long-Term Follow-up After an Initial Episode of Diverticulitis: What Are the Predictors of Recurrence?

Hall, Jason F.; Roberts, Patricia L.; Ricciardi, Rocco; Read, Thomas E.; Scheirey, Christopher D.; Wald, Christoph; Marcello, Peter W.; Schoetz, David J.

doi:10.1007/dcr.0b013e3182028576

Cited by 206 publications

(150 citation statements)

References 20 publications

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“…Of those patients, about 85% will have uncomplicated disease [5]. Furthermore, recurrence occurs in about 13.3-23.4% of people with diverticulitis [6][7][8][9]. This is in contrast to earlier studies that estimated a recurrence rate of about 25-45% [10][11][12].…”

Section: Introductioncontrasting

confidence: 52%

Antibiotics in Uncomplicated Acute Diverticulitis: To Give or Not to Give?

Rezapour

Stollman

2018

Inflamm Intest Dis

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Acute uncomplicated diverticulitis (AUD) is generally felt to be caused by obstruction and inflammation of a colonic diverticulum and occurs in about 4-5% of patients with diverticulosis. The cornerstone of AUD treatment has conventionally been antibiotic therapy, but with a paradigm shift in the underlying pathogenesis of the disease from bacterial infection to more of an inflammatory process, as well as concerns about antibiotic overuse, this dogma has recently been questioned. We will review emerging data that supports more selective antibiotic use in this population, as well as newer guidelines that advocate this position as well. While there are no discrete algorithms to guide us, we will attempt to suggest clinical scenarios where antibiotics may reasonably be withheld.

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Section: Introductioncontrasting

confidence: 52%

Antibiotics in Uncomplicated Acute Diverticulitis: To Give or Not to Give?

Rezapour

Stollman

2018

Inflamm Intest Dis

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“…After successful medical treatment of the acute episode, patients with severe diverticulitis on CT had a statistically greater incidence of secondary bad outcome than patients with moderate diverticulitis (36 vs. 17 %) [142,143]. Hall [144] showed in a multivariate analysis of 672 patents that left-sided AD, length of involved colon [5 cm and a retroperitoneal abscess were predictors for recurrence. However, the study could not report a multivariate model for complicated recurrence because of the small number of events.…”

Section: What Are the Actual Indications For Elective Surgery?mentioning

confidence: 99%

Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines

et al. 2015

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The mission of the Italian Society of Colorectal Surgery (SICCR) is to optimize patient care. Providing evidence-based practice guidelines is therefore of key importance. About the present report it concernes the SICCR practice guidelines for the diagnosis and treatment of diverticular disease of the colon. The guidelines are not intended to define the sole standard of care but to provide evidence-based recommendations regarding the available therapeutic options.

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“…8 More recently, a 5-year recurrence of 36% (95% CI, 31.4-40.6%) was reported in a retrospective study of 672 patients admitted with acute diverticulitis. 9 Of 221 patients treated medically following a first admission with acute diverticulitis, overall readmission was 20.8% (46/221). 10 A further study of 502 patients from New Zealand reported a recurrence rate of 18.8% (60/320) with a median follow-up of 101 months and no increase in mortality related to recurrent episodes.…”

Section: Epidemiology and Pathogenesismentioning

confidence: 99%

Review article: the pathogenesis and management of acute colonic diverticulitis

Humes

Spiller

2014

Aliment Pharmacol Ther

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SummaryBackgroundAcute diverticulitis, defined as acute inflammation associated with a colonic diverticulum, is a common emergency presentation managed by both surgeons and physicians. There have been advances in both the medical and the surgical treatments offered to patients in recent years.AimTo review the current understanding of the aetiology and treatment of acute diverticulitis.MethodsA search of PubMed and Medline databases was performed to identify articles relevant to the aetiology, pathogenesis and management of acute diverticulitis.ResultsThere are 75 hospital admissions per year for acute diverticulitis per 100 000 of the population in the United States. Recent reports suggest a 26% increase in admissions over a 7‐year period. Factors predisposing to the development of acute diverticulitis include obesity, smoking, diet, lack of physical activity and medication use such as aspirin and nonsteroidal anti‐inflammatory drugs. The condition is associated with a low mortality of about 1% following medical therapy, rising to 4% in‐hospital mortality in those requiring surgery. There is limited evidence on the efficacy of individual antibiotic regimens, and antibiotic treatment may not be required in all patients. The rates of recurrence reported for patients with acute diverticulitis following medical management vary from 13% to 36%. The surgical management of those patients who fail medical treatment has moved towards a laparoscopic nonresectional approach; however, the evidence supporting this is limited.ConclusionsFurther high‐quality randomised controlled trials are required of both medical and surgical treatments in patients with acute diverticulitis, if management is to be evidence‐based.

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Long-Term Follow-up After an Initial Episode of Diverticulitis: What Are the Predictors of Recurrence?

Cited by 206 publications

References 20 publications

Antibiotics in Uncomplicated Acute Diverticulitis: To Give or Not to Give?

Antibiotics in Uncomplicated Acute Diverticulitis: To Give or Not to Give?

Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines

Review article: the pathogenesis and management of acute colonic diverticulitis

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