Image-guided conservative management of right colonic diverticulitis

World J Gastroenterol. 2009 Dec 14;15(46):5838-42. doi: 10.3748/wjg.15.5838.

Abstract

Aim: To study the clinical outcomes of medical therapy in patients with right colonic diverticulitis.

Methods: The records of 189 patients with right colonic diverticulitis which was finally diagnosed by computed tomography, ultrasonography, or operative findings were retrospectively reviewed.

Results: Of the 189 patients hospitalized for right colonic diverticulitis, the stages of diverticulitis by a modified Hinchey classification were 26 patients (13.8%) in stage 0, 139 patients (73.5%) in stage Ia, 23 patients (12.2%) in stage Ib, and 1 patient (0.5%) in stage III. Medical therapy was undertaken in 185 of 189 patients (97.9%). One hundred and eighty three of 185 patients were successfully treated with bowel rest and antibiotics. Two patients in stage Ib required a resection or surgical drainage because of an inadequate response to conservative treatment. Recurrent diverticulitis developed in 15 of 183 patients (8.2%) who responded to medical therapy. All 15 patients who suffered a second attack had uncomplicated diverticulitis, and were successfully treated with medical therapy.

Conclusion: Our results indicate that right colonic diverticulitis is essentially benign and image-guided conservative treatment is primarily required.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Colon* / anatomy & histology
  • Colon* / pathology
  • Diagnostic Imaging
  • Diverticulitis, Colonic* / pathology
  • Diverticulitis, Colonic* / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult