Recurrent Left Colonic Diverticulitis Episodes: More Severe Than the Initial Diverticulitis?

Pittet, Olivier; Kotzampassakis, Nikos; Schmidt, Sabine; Denys, Alban; Demartines, Nicolas; Calmes, Jean-Marie

doi:10.1007/s00268-008-9898-9

Cited by 56 publications

(44 citation statements)

References 25 publications

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“…Moreover, the risk of severe complications, as perforation, is usually associated with the first episode of AD [112,[119][120][121]124]. A recent nationwide study [125] confirms that a less aggressive strategy is not associated with an increase in complicated diverticulitis at recurrence.…”

Section: Elective Surgery For Diverticular Diseasementioning

confidence: 79%

“…More recently, many studies have questioned these indications primarily because the majority of patients experience an acute complication at their first presentation of DD, the long-term risk of relapse is quite low [114][115][116][117][118], recurrent episodes of uncomplicated diverticulitis do not lead to failure of conservative treatment or to an increased risk of poor outcomes if patients develop complicated diverticulitis [119,120], and most important of all, the long-term risks of subsequent emergent surgery, stoma formation and death are low [114,115,[121][122][123]. Moreover, the risk of severe complications, as perforation, is usually associated with the first episode of AD [112,[119][120][121]124].…”

Section: Elective Surgery For Diverticular Diseasementioning

confidence: 99%

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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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Section: Elective Surgery For Diverticular Diseasementioning

confidence: 79%

Section: Elective Surgery For Diverticular Diseasementioning

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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“…20 This thesis is underlined by several other studies, which have shown that complicated diverticulitis most commonly occurred during the first episode rather than during recurrent episodes. [21][22][23] Therefore, the aim in IS patients is to avoid diverticulitis. Smoking and obesity are known to increase the incidence of diverticulitis and complicated diverticulitis [24][25][26][27] ; in contrast physical activity prevents diverticulitis and reduces the risk of complicated diverticulitis.…”

Section: Discussionmentioning

confidence: 99%

Diverticulitis in immunosuppressed patients: A fatal outcome requiring a new approach?

Brandl

Kratzer

Kafka-Ritsch

et al. 2016

cjs

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“…There have been numerous reports of a decreasing risk of perforation with the number of episodes of diverticulitis [120,121,122]. …”

Section: Outpatient/inpatient Treatment Conservative/surgical Treatmentmentioning

confidence: 99%

Diverticular Disease: Guidelines of the German Society for Gastroenterology, Digestive and Metabolic Diseases and the German Society for General and Visceral Surgery

Kruis

Germer²,

Leifeld³

et al. 2014

Digestion

134

117

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Background: Diverticular disease is one of the most common disorders of the gastrointestinal tract. 28-45% of the population develop colonic diverticula, while about 25% suffer symptoms and about 5% complications. Aim: To create formal guidelines for diagnosis and management. Methods: Six working groups with 44 participants analyzed key questions in subject areas assigned to them. Following a systematic literature search, 451 publications were included. Consensus was obtained by agreement within the working groups, two Delphi processes and a guideline conference. Results: Targeted management of diverticular disease requires a classificatory diagnosis. A new classification was created. In addition to the clinical examination, intestinal ultrasound or computed tomography is the determining factor. Interval colonoscopy is recommended to exclude comorbidities. A low-fiber diet, obesity, lack of exercise, smoking and immunosuppression have an adverse impact on diverticulosis. This can lead to diverticulitis. Antibiotics are no longer recommended in uncomplicated diverticulitis if no risk factors such as immunosuppression are present. If close monitoring is ensured, uncomplicated diverticulitis can be treated on an outpatient basis. Complicated diverticulitis should be treated in hospital, involving broad-spectrum antibiotic therapy, where necessary abscess drainage, and surgery, if possible laparoscopically. In the case of chronic relapsing diverticulitis, the risk of perforation decreases with each episode, so that surgery is no longer recommended after the second episode but only following individual assessment. Conclusions: New findings on diverticular disease call into question the overuse of antibiotics and excessive indications for surgery. Targeted treatment requires a precise diagnosis and intensive interdisciplinary cooperation. i 2014 S. Karger AG, Basel

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Recurrent Left Colonic Diverticulitis Episodes: More Severe Than the Initial Diverticulitis?

Abstract: Recurrent episodes of diverticulitis do not lead to more complications and more conservative treatment failure. Moreover, surgery at admission was less frequent among patients who presented with a recurrence.

Cited by 56 publications

References 25 publications

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

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

Diverticulitis in immunosuppressed patients: A fatal outcome requiring a new approach?

Diverticular Disease: Guidelines of the German Society for Gastroenterology, Digestive and Metabolic Diseases and the German Society for General and Visceral Surgery

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