Advertisement

Techniques in Coloproctology

, Volume 19, Issue 10, pp 615–626 | Cite as

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

  • G. A. Binda
  • R. Cuomo
  • A. Laghi
  • R. Nascimbeni
  • A. Serventi
  • D. Bellini
  • P. Gervaz
  • B. Annibale
Clinical Guidelines

Abstract

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.

Keywords

Diverticulosis Diverticular disease Diverticulitis Colon 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study informed consent is not required.

References

  1. 1.
    Guyatt G, Gutterman D, Baumann MH et al (2006) Grading strength of recommendations and quality of evidence in clinical guide-lines: report from an american College of Chest Physicians task force. Chest 129:174–181PubMedCrossRefGoogle Scholar
  2. 2.
    Jung HK, Choung RS, Locke GR III, Schleck CD, Zinsmeister AR, Talley NJ (2010) Diarrhea predominant irritable bowel syndrome is associated with diverticular disease: a population-based study. Am J Gastroenterol 105:652–661PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Salem TA, Molloy RG, O’Dwyer PJ (2007) Prospective, five years follow-up study of patients with symptomatic uncomplicated diverticular disease. Dis Colon Rectum 50:1460–1464PubMedCrossRefGoogle Scholar
  4. 4.
    Hinchey EJ, Schaal PG, Richard GK (1978) Treatment of diverticular disease of the colon. Adv Surg 12:85–109PubMedGoogle Scholar
  5. 5.
    Everhart JE, Ruhl CE (2009) Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterology 136:741–754PubMedCrossRefGoogle Scholar
  6. 6.
    Heise CP (2008) Epidemiology and pathogenesis of diverticular disease. J Gastrointest Surg 12:1309–1311PubMedCrossRefGoogle Scholar
  7. 7.
    Etzioni DA, Mack TM, Beart RW (2009) Diverticulitis in the United States: 1998–2005: changing patterns of disease and treatment. Ann Surg 249:210–217PubMedCrossRefGoogle Scholar
  8. 8.
    Warner E, Crighton EJ, Moineddin R (2007) Fourteen-year study of hospital admissions for diverticular disease in Ontario. Can J Gastroenterol 21:97–99PubMedPubMedCentralGoogle Scholar
  9. 9.
    Kang JY, Hoare J, Tinto A (2003) Diverticular disease of the colon—on the rise: a study of hospital admission in England between 1989/1990 and 1999/2000. Aliment Pharmacol Ther 17:1189–1195PubMedCrossRefGoogle Scholar
  10. 10.
    Painter NS, Burkitt DP (1971) Diverticular disease of the colon: a deficiency disease of Western civilization. Brit Med J 2:450–454PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Gear JS, Ware A, Fursdon P et al (1979) Symptomless diverticular disease and intake of dietary fibre. Lancet 1:511–514PubMedCrossRefGoogle Scholar
  12. 12.
    Crowe FL, Appleby PN, Allen NE, Key TJ (2011) Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians. BMJ 343:d4131PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Crowe FL, Balkwill A, Cairns BJ et al, Million Women Study Collaborators (2014) Source of dietary fibre and diverticular disease incidence: a prospective study of UK women. Gut 63:1450–1456Google Scholar
  14. 14.
    Strate LL, Liu YL, Syngal S, Aldoori WH, Giovannucci EL (2008) Nut, corn, and popcorn consumption and the incidence of diverticular disease. JAMA 300:907–914PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Song JH, Kim YS, Lee JH et al (2010) Clinical characteristics of colonic diverticulosis in Korea: a prospective study. Korean J Intern Med 25:140–146PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Peery AF, Barrett PR, Park D et al (2012) A high-fiber diet does not protect against asymptomatic diverticulosis. Gastroenterology 142:266–272PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Bassotti G, Battaglia E, De Roberto G, Morelli A, Tonini M, Villanacci V (2005) Alterations in colonic motility and relationship to pain in colonic diverticulosis. Clin Gastroenterol Hepatol 3:248–253PubMedCrossRefGoogle Scholar
  18. 18.
    Cuomo R, Barbara G, Andreozzi P et al (2013) Symptom patterns can distinguish diverticular disease from irritable bowel syndrome. Eur J Clin Invest 43:1147–1155PubMedGoogle Scholar
  19. 19.
    Bassotti G, Villanacci V, Nascimbeni R et al (2013) The role of colonic mast cells and myenteric plexitis in patients with diverticular disease. Int J Colorectal Dis 28:267–272PubMedCrossRefGoogle Scholar
  20. 20.
    Tursi A, Elisei W, Brandimarte G et al (2010) Predictive value of serologic markers of degree of histologic damage in acute uncomplicated colonic diverticulitis. J Clin Gastroenterol 44:702–706PubMedCrossRefGoogle Scholar
  21. 21.
    Spiller R (2012) Is it diverticular disease or is it irritable bowel syndrome? Dig Dis 30:64–69PubMedCrossRefGoogle Scholar
  22. 22.
    Cohen ER, Fuller G, Bolus R et al (2012) Evidence for postdiverticulitis irritable bowel syndrome (Pdv-IBS): longitudinal analysis reveals higher incidence of IBS in DV cases vs. controls. Gastroenterology 5:S811–S812CrossRefGoogle Scholar
  23. 23.
    Atkin W, Dadswell E, Wooldrage K et al, SIGGAR Investigators (2013) Computed tomographic colonography versus colonoscopy for investigation of patients with symptoms suggestive of colorectal cancer (SIGGAR): a multicentre randomised trial. Lancet 381:1194–1202Google Scholar
  24. 24.
    Cuomo R, Barbara G, Pace F et al (2014) Italian consensus conference for colonic diverticulosis and diverticular disease. United European Gastroenterol J 2:413–442PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    De Cecco C, Ciolina M, Annibale B et al (2015) Prevalence and distribution of colonic diverticula assessed with CT colonography (CTC). Eur Radiol. doi: 10.1007/s00330-015-3866-1
  26. 26.
    Gollub MJ, Jhaveri S, Schwartz E et al (2005) CT colonography features of sigmoid diverticular disease. Clin Imaging 29:200–206PubMedCrossRefGoogle Scholar
  27. 27.
    Lefere P, Gryspeerdt S, Baekelandt M, Dewyspelaere J, van Holsbeeck B (2003) Diverticular disease in CT colonography. Eur Radiol 13(Suppl 4):L62–L74PubMedCrossRefGoogle Scholar
  28. 28.
    Brewster NT, Grieve DC, Saunders JH (1994) Double-contrast barium enema and flexible sigmoidoscopy for routine colonic investigation. Br J Surg 81:445–447PubMedCrossRefGoogle Scholar
  29. 29.
    von Wagner C, Smith S, Halligan S et al (2011) Patient acceptability of CT colonography compared with double contrast barium enema: results from a multicentre randomised controlled trial of symptomatic patients. Eur Radiol 21:2046–2055CrossRefGoogle Scholar
  30. 30.
    Pendse DA, Taylor SA (2013) Complications of CT colonography: a review. Eur J Radiol 82:1159–1165PubMedCrossRefGoogle Scholar
  31. 31.
    Flicek KT, Hara AK, Silva AC, Wu Q, Peter MB, Johnson CD (2010) Reducing the radiation dose for CT colonography using adaptive statistical iterative reconstruction: a pilot study. AJR Am J Roentgenol 195:126–131PubMedCrossRefGoogle Scholar
  32. 32.
    Neri E, Faggioni L, Cerri F et al (2010) CT colonography versus double-contrast barium enema for screening of colorectal cancer: comparison of radiation burden. Abdom Imaging 35:596–601PubMedCrossRefGoogle Scholar
  33. 33.
    Neri E, Halligan S, Hellstrom M et al, ESGAR CT Colonography Working Group (2013) The second ESGAR consensus statement on CT colonography. Eur Radiol 23:720–729Google Scholar
  34. 34.
    Yoon MA, Kim SH, Lee JM et al (2012) Adaptive statistical iterative reconstruction and Veo: assessment of image quality and diagnostic performance in CT colonography at various radiation doses. J Computer Assist Tomogr 36:596–601CrossRefGoogle Scholar
  35. 35.
    Puylaert JB (2012) Ultrasound of colon diverticulitis. Dig Dis 30:56–59PubMedCrossRefGoogle Scholar
  36. 36.
    Schreyer AG, Furst A, Agha A et al (2004) Magnetic resonance imaging based colonography for diagnosis and assessment of diverticulosis and diverticulitis. Int J Colorectal Dis 19:474–480PubMedCrossRefGoogle Scholar
  37. 37.
    Thornton E, Morrin MM, Yee J (2010) Current status of MR colonography. Radiographics 30:201–218PubMedCrossRefGoogle Scholar
  38. 38.
    Toorenvliet BR, Bakker RF, Breslau PJ, Merkus JW, Hamming JF (2010) Colonic diverticulitis: a prospective analysis of diagnostic accuracy and clinical decision-making. Colorectal Dis 12:179–186PubMedCrossRefGoogle Scholar
  39. 39.
    Liljegren G, Chabok A, Wickbom M, Smedh K, Nilsson K (2007) Acute colonic diverticulitis: a systematic review of diagnostic accuracy. Colorectal Dis 9:480–488PubMedCrossRefGoogle Scholar
  40. 40.
    van Randen A, Lameris W, van Es HW et al, OPTIMA Study Group (2011) A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain. Eur Radiol 21:1535–1545Google Scholar
  41. 41.
    Halligan S, Saunders B (2002) Imaging diverticular disease. Best Pract Res Clin Gastroenterol 16:595–610PubMedCrossRefGoogle Scholar
  42. 42.
    Hainaux B, Agneessens E, Bertinotti R et al (2006) Accuracy of MDCT in predicting site of gastrointestinal tract perforation. AJR Am J Roentgenol 187:1179–1183PubMedCrossRefGoogle Scholar
  43. 43.
    Buckley O, Geoghegan T, O’Riordain DS, Lyburn ID, Torreggiani WC (2004) Computed tomography in the imaging of colonic diverticulitis. Clin Radiol 59:977–983PubMedCrossRefGoogle Scholar
  44. 44.
    Kaiser AM, Jiang JK, Lake JP et al (2005) The management of complicated diverticulitis and the role of computed tomography. Am J Gastroenterol 100:910–917PubMedCrossRefGoogle Scholar
  45. 45.
    Andeweg CS, Wegdam JA, Groenewoud J, van der Wilt GJ, van Goor H, Bleichrodt RP (2014) Toward an evidence-based step-up approach in diagnosing diverticulitis. Scand J Gastroenterol 49:775–784PubMedCrossRefGoogle Scholar
  46. 46.
    Lameris W, van Randen A, van Es HW et al, OPTIMA Study Group (2009) Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. BMJ 338:b2431Google Scholar
  47. 47.
    Lameris W, van Randen A, van Gulik TM et al (2010) A clinical decision rule to establish the diagnosis of acute diverticulitis at the emergency department. Dis Colon Rectum 53:896–904PubMedCrossRefGoogle Scholar
  48. 48.
    Cho KC, Morehouse HT, Alterman DD, Thornhill BA (1990) Sigmoid diverticulitis: diagnostic role of CT-comparison with barium enema studies. Radiology 176:111–115PubMedCrossRefGoogle Scholar
  49. 49.
    Stefansson T, Nyman R, Nilsson S, Ekbom A, Pahlman L (1997) Diverticulitis of the sigmoid colon. A comparison of CT, colonic enema and laparoscopy. Acta Radiol 38:313–319PubMedGoogle Scholar
  50. 50.
    Heverhagen JT, Sitter H, Zielke A, Klose KJ (2008) Prospective evaluation of the value of magnetic resonance imaging in suspected acute sigmoid diverticulitis. Dis Colon Rectum 51:1810–1815PubMedCrossRefGoogle Scholar
  51. 51.
    Ajaj W, Ruehm SG, Lauenstein T et al (2005) Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study. Eur Radiol 15:2316–2322PubMedCrossRefGoogle Scholar
  52. 52.
    Herman LL, Kurtz RC, McKee KJ, Sun M, Thaler HT, Winawer SJ (1993) Risk factors associated with vasovagal reactions during colonoscopy. Gastrointest Endosc 39:388–391PubMedCrossRefGoogle Scholar
  53. 53.
    Williams C, Teague R (1973) Colonoscopy. Gut 14:990–1003PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Dafnis G, Granath F, Pahlman L, Ekbom A, Blomqvist P (2005) Patient factors influencing the completion rate in colonoscopy. Dig Liver Dis 37:113–118PubMedCrossRefGoogle Scholar
  55. 55.
    Hjern F, Jonas E, Holmstrom B, Josephson T, Mellgren A, Johansson C (2007) CT colonography versus colonoscopy in the follow-up of patients after diverticulitis—a prospective, comparative study. Clin Radiol 62:645–650PubMedCrossRefGoogle Scholar
  56. 56.
    van Gelder RE, Birnie E, Florie J et al (2004) CT colonography and colonoscopy: assessment of patient preference in a 5-week follow-up study. Radiology 233:328–337PubMedCrossRefGoogle Scholar
  57. 57.
    Chabok A, Smedh K, Nilsson S, Stenson M, Pahlman L (2013) CT-colonography in the follow-up of acute diverticulitis: patient acceptance and diagnostic accuracy. Scand J Gastroenterol 48:979–986PubMedCrossRefGoogle Scholar
  58. 58.
    Aldoori WH, Giovannucci EL, Rimm EB, Wing AL, Trichopoulos DV, Willett WC (1994) A prospective study of diet and the risk of symptomatic diverticular disease in men. Am J Clin Nutr 60:757–764PubMedGoogle Scholar
  59. 59.
    Aldoori W, Ryan-Harshman M (2002) Preventing diverticular disease. Review of recent evidence on high-fibre diets. Can Fam Physician 48:1632–1637PubMedPubMedCentralGoogle Scholar
  60. 60.
    Unlu C, Daniels L, Vrouenraets BC, Boermeester MA (2012) A systematic review of high-fiber dietary therapy in diverticular disease. Int J Colorectal Dis 27:419–427PubMedPubMedCentralCrossRefGoogle Scholar
  61. 61.
    Maconi G, Barbara G, Bosetti C, Cuomo R, Annibale B (2011) Treatment of diverticular disease of the colon and prevention of acute diverticulitis: a systematic review. Dis Colon Rectum 54:1326–1338PubMedCrossRefGoogle Scholar
  62. 62.
    Latella G, Pimpo MT, Sottili S et al (2003) Rifaximin improves symptoms of acquired uncomplicated diverticular disease of the colon. Int J Colorectal Dis 18:55–62PubMedCrossRefGoogle Scholar
  63. 63.
    Colecchia A, Vestito A, Pasqui F et al (2007) Efficacy of long term cyclic administration of the poorly absorbed antibiotic Rifaximin in symptomatic, uncomplicated colonic diverticular disease. World J Gastroenterol 13:264–269PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Ventrucci M, Ferrieri A, Bergami R, Roda E (1994) Evaluation of the effect of rifaximin in colon diverticular disease by means of lactulose hydrogen breath test. Curr Med Res Opin 13:202–206PubMedCrossRefGoogle Scholar
  65. 65.
    Colecchia A, Sandri L, Capodicasa S et al (2003) Diverticular disease of the colon: new perspectives in symptom development and treatment. World J Gastroenterol 9:1385–1389PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Pimentel M, Lembo A, Chey W et al, TARGET Study Group (2011) Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med 364:22–32Google Scholar
  67. 67.
    Bianchi M, Festa V, Moretti A et al (2011) Meta-analysis: long-term therapy with rifaximin in the management of uncomplicated diverticular disease. Aliment Pharmacol Ther 33:902–910PubMedCrossRefGoogle Scholar
  68. 68.
    Horgan A, McConnell E, Wolff B, The S, Paterson C (2001) Atypical diverticular diseases: surgical results. Dis Colon Rectum 44:1315–1318PubMedCrossRefGoogle Scholar
  69. 69.
    Tursi A (2007) New physiopathological and therapeutic approaches to diverticular disease of the colon. Expert Opin Pharmacother 8:299–307PubMedCrossRefGoogle Scholar
  70. 70.
    Trespi E, Colla C, Panizza P et al (1999) Therapeutic and prophylactic role of mesalazine (5-Asa) in symptomatic diverticular disease of the large intestine. 4 year follow-up results. Minerva Gastroenterol Dietol 45:245–252Google Scholar
  71. 71.
    Tursi A, Brandimarte G, Giorgetti G, Elisei W (2007) Continuous versus cyclic mesalazine therapy for patients affected by recurrent symptomatic uncomplicated diverticular disease of the colon. Dig Dis Sci 52:671–674PubMedCrossRefGoogle Scholar
  72. 72.
    Stollman N, Magowan S, Shanahan F, Quigley EM; DIVA Investigator Group (2013) A randomized controlled study of mesalamine after acute diverticulitis: Results of the DIVA trial. J Clin Gastroenterol 47:621–629Google Scholar
  73. 73.
    Kruis W, Meier E, Schumacher M, Michkisch O, Greinwald R, Mueller R, German SAG-20 Study Group (2013) Randomised clinical trial: mesalazine (Salofalk granules) for uncomplicated diverticular disease of the colon–a placebo-controlled study. Aliment Pharmacol Ther 37:680–690PubMedCrossRefGoogle Scholar
  74. 74.
    Tursi A, Brandimarte G, Daffina R (2002) Long-term treatment with mesalazine and rifaximin versus rifaximin alone for patients with recurrent attacks of acute diverticulitis of colon. Dig Liver Dis 34:510–515PubMedCrossRefGoogle Scholar
  75. 75.
    Di Mario F, Aragona G, Leandro G et al (2005) Efficacy of mesalazine in the treatment of symptomatic diverticular disease. Dig Dis Sci 50:581–586PubMedCrossRefGoogle Scholar
  76. 76.
    Sanders ME (2008) Probiotics: definition, sources, selection, and uses. Clin Infect Dis 46:S58–S61PubMedCrossRefGoogle Scholar
  77. 77.
    Sullivan A, Nord CE (2005) Probiotics and gastrointestinal disease. J Intern Med 257:78–92PubMedCrossRefGoogle Scholar
  78. 78.
    Gill HS (2003) Probiotics to enhance anti-infective defences in the gastrointestinal tract. Best Practice Res Clin Gastroenterol 17:755–773CrossRefGoogle Scholar
  79. 79.
    Narula N, Marshall JK (2010) Role of probiotics in management of diverticular disease. J Gastroenterol Hepatol 25:1827–1830PubMedCrossRefGoogle Scholar
  80. 80.
    Tursi A, Brandimarte G, Giorgetti GM, Elisei W (2006) Mesalazine and/or Lactobacillus casei in preventing recurrence of symptomatic uncomplicated diverticular disease of the colon: a prospective, randomized, open-label study. J Clin Gastroenterol 40:312–316PubMedCrossRefGoogle Scholar
  81. 81.
    Tursi A, Brandimarte G, Giorgetti GM, Elisei W (2008) Mesalazine and/or Lactobacillus casei in maintaining long-term remission of symptomatic uncomplicated diverticular disease of the colon. Hepatogastroenterology 55:916–920PubMedGoogle Scholar
  82. 82.
    Tursi A, Brandimarte G, Elisei W et al (2013) Randomised clinical trial: mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease a double-blind, randomized, placebo-controlled study. Aliment Pharmacol Ther 38:741–751PubMedCrossRefGoogle Scholar
  83. 83.
    Tursi A, Brandimarte G, Giorgetti GM, Elisei W, Aiello F (2007) Balsalazide and/or high-potency probiotic mixture (VSL#3) in maintaining remission after attack of acute, uncomplicated diverticulitis of the colon. Int J Colorectal Dis 22:1103–1108PubMedCrossRefGoogle Scholar
  84. 84.
    Lamiki P, Tsuchiya J, Pathak S et al (2010) Probiotics in diverticular disease of the colon: an open label study. J Gastrointestin Liver Dis 19:31–36PubMedGoogle Scholar
  85. 85.
    Annibale B, Maconi G, Lahner E, De Giorgi F, Cuomo R (2011) Efficacy of Lactobacillus paracasei sub. paracasei F19 on abdominal symptoms in patients with symptomatic uncomplicated diverticular disease: a pilot study. Minerva Gastroenterol Dietol 57:1–10Google Scholar
  86. 86.
    Lahner E, Esposito G, Zullo A et al (2012) High-fibre diet and Lactobacillus paracasei B21060 in symptomatic uncomplicated diverticular disease. World J Gastroenterol 18:5918–5924PubMedPubMedCentralCrossRefGoogle Scholar
  87. 87.
    Lanas A, Ponce J, Bignamini A, Mearin F (2013) One year intermittent rifaximin plus fibre supplementation vs. fibre supplementation alone to prevent diverticulitis recurrence: a proof-of-concept study. Dig Liver Dis 45:104–109PubMedCrossRefGoogle Scholar
  88. 88.
    Conte D, Orlando S (2013) Rifaximin plus fibre versus fibre alone in preventing diverticulitis recurrence: a (problematic) trial to tackle an epidemiologically relevant problem. Dig Liver Dis 45:102–103PubMedCrossRefGoogle Scholar
  89. 89.
    Humes D, Smith JK, Spiller RC (2011) Colonic diverticular disease. Clinical Evidence 14:pii0405Google Scholar
  90. 90.
    Parente F, Bargiggia S, Prada A et al, Gismi Study Group (2013) Intermittent treatment with mesalazine in the prevention of diverticulitis recurrence: A randomized multicenter pilot double-blind placebo-controlled study of 24-month duration. Int J Colorectal Dis 28:1423–1431Google Scholar
  91. 91.
    Comparato G, Fanigliulo L, Cavallaro LG et al (2007) Prevention of complications and symptomatic recurrences in diverticular disease with mesalazine: a 12-month follow-up. Dig Dis Sci 52:2934–2941PubMedCrossRefGoogle Scholar
  92. 92.
    Tursi A, Elisei W, Giorgetti GM et al (2013) Effectiveness of different therapeutic strategies in preventing diverticulitis recurrence. Eur Rev Med Pharmacol Sci 17:342–348PubMedGoogle Scholar
  93. 93.
    Raskin JB, Kamm MA, Jamal MM et al (2014) Mesalamine did not prevent recurrent diverticulitis in phase 3 controlled trials. Gastroenterology 147:793–802PubMedCrossRefGoogle Scholar
  94. 94.
    Chabok A, Pahlman L, Hjern F, Haapaniemi S, Smedh K, AVOD Study Group (2012) Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg 99:532–539PubMedCrossRefGoogle Scholar
  95. 95.
    Andersen JC, Bundgaard L, Elbrond H, Laurberg S, Walker LR, Støvring J, Danish Surgical Society (2012) Danish national guidelines for treatment of diverticular disease. Dan Med J 59:C4453PubMedGoogle Scholar
  96. 96.
    Westwood DA, Eglinton TW (2013) Antibiotics may not improve short-term or long-term outcomes in acute uncomplicated diverticulitis. Evid Based Med 18:32–33PubMedCrossRefGoogle Scholar
  97. 97.
    Hjern F, Josephson T, Altman D et al (2007) Conservative treatment of acute colonic diverticulitis: Are antibiotics always mandatory? Scand J Gastroenterol 42:41–44PubMedCrossRefGoogle Scholar
  98. 98.
    Ūnlü C, de Korte N, Daniels L et al, Dutch Diverticular Disease 3D Collaborative Study Group (2010) A multicenter randomized clinical trial investigating the cost-effectiveness of treatment strategies with or without antibiotics for uncomplicated acute diverticulitis (DIABOLO trial). BMC Surg 10:23Google Scholar
  99. 99.
    De Korte N, Klarenbeek BR, Kuyvenhoven JP, Roumen RM, Cuesta MA, Stockmann HB (2011) Management of diverticulitis: results of a survey among gastroenterologists and surgeons. Colorectal Dis 13:e411–e417PubMedCrossRefGoogle Scholar
  100. 100.
    Biondo S, Lopez Borao J, Millan M, Kreisler E, Jaurrieta E (2012) Current status of the treatment of acute colonic diverticulitis: a systematic review. Colorectal Dis 14:e1–e11PubMedCrossRefGoogle Scholar
  101. 101.
    Moya P, Arroyo A, Pérez-Legaz J et al (2012) Applicability, safety and efficiency of outpatient treatment in uncomplicated diverticulitis. Tech Coloproctol 16:301–307PubMedCrossRefGoogle Scholar
  102. 102.
    Unlü C, Gunadi PM, Gerhards MF, Boermeester MA, Vrouenraets BC (2013) Outpatient treatment for acute uncomplicated diverticulitis. Eur J Gastroenterol Hepatol 25:1038–1043PubMedCrossRefGoogle Scholar
  103. 103.
    Biondo S, Golda T, Kreisler E et al (2014) Outpatients versus hospitalisation management for uncomplicated diverticulitis: a prospective, multicenter randomised clinical trial (DIVER Trial). Ann Surg 259:38–44PubMedCrossRefGoogle Scholar
  104. 104.
    Lorente L, Cots F, Alonso S et al (2013) Outpatient treatment of uncomplicated acute diverticulitis: impact on healthcare costs. Cir Esp 91:504–509PubMedCrossRefGoogle Scholar
  105. 105.
    Jackson JD, Hammond T (2014) Systematic review: outpatient management of acute uncomplicated diverticulitis. Int J Colorectal Dis 29:775–781PubMedCrossRefGoogle Scholar
  106. 106.
    Shabanzadeh DM, Wille-Jørgensen P (2012) Antibiotics for uncomplicated diverticulitis. Cochrane Database Syst Rev 11:9092Google Scholar
  107. 107.
    Stollman NH, Raskin JB (1999) Diagnosis and management of diverticular disease of the colon in adults. Ad Hoc Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 94:3110–3121PubMedCrossRefGoogle Scholar
  108. 108.
    Roberts P, Abel M, Rosen L et al (1995) Practice parameters for sigmoid diverticulitis. The Standards Task Force American Society of Colon and Rectal Surgeons. Dis Colon Rectum 38:125–132PubMedCrossRefGoogle Scholar
  109. 109.
    Köhler L, Sauerland S, Neugebauer E (1999) Diagnosis and treatment of diverticular disease: results of a consensus development conference. The Scientific Committee of the European Association for Endoscopic Surgery. Surg Endosc 13:430–436PubMedCrossRefGoogle Scholar
  110. 110.
    Parks TG (1969) Natural history of diverticular disease of the colon. A review of 521 cases. BMJ IV:639–642CrossRefGoogle Scholar
  111. 111.
    Farmakis N, Tudor RG, Keighley MRB (1994) The 5-year natural history of complicated diverticular disease. Br J Surg 84:733–735CrossRefGoogle Scholar
  112. 112.
    Janes S, Meagher A, Frizelle FA (2005) Elective surgery after acute diverticulitis. Br J Surg 92:133–142PubMedCrossRefGoogle Scholar
  113. 113.
    Rafferty J, Shellito P, Hyman NH, Buie WD (2006) Recommendations of the standard committee, ASCRS practice parameters for sigmoid diverticulitis. Dis Colon Rectum 49:939–944PubMedCrossRefGoogle Scholar
  114. 114.
    Eglinton T, Nguyen T, Raniga S, Dixon L, Dobbs B, Frizelle FA (2010) Patterns of recurrence in patients with acute diverticulitis. Br J Surg 97:952–957PubMedCrossRefGoogle Scholar
  115. 115.
    Binda GA, Arezzo A, Serventi A, Bonelli L, GISDIC (2012) Natural history of left-sided acute diverticulitis: a multicenter prospective study. Br J Surg 99:276–285PubMedCrossRefGoogle Scholar
  116. 116.
    Broderick-Villa G, Burchette RJ, Collins JC, Abbas MA, Haigh PI (2005) Hospitalization for acute diverticulitis does not mandate routine elective colectomy. Arch Surg 140:576–581PubMedCrossRefGoogle Scholar
  117. 117.
    Anaya DA, Flum DR (2005) Risk of emergency colectomy and colostomy in patients with diverticular disease. Arch Surg 140:681–685PubMedCrossRefGoogle Scholar
  118. 118.
    Li D, de Mestral C, Baxter NN et al (2014) Risk of readmission and emergency surgery following nonoperative management of colonic diverticulitis: a population based analysis. Ann Surg 260:423–430PubMedCrossRefGoogle Scholar
  119. 119.
    Chapman J, Davies M, Wolff B et al (2005) Complicated diverticulitis: Is it time to rethink the rules? Ann Surg 242:576–581PubMedPubMedCentralGoogle Scholar
  120. 120.
    Pittet O, Kotzampassakis N, Schmidt S, Denys A, Demartines N, Calmes JM (2009) Recurrent left colonic diverticulitis episodes: More severe than the initial diverticulitis? World J Surg 33:547–552PubMedCrossRefGoogle Scholar
  121. 121.
    Ritz JP, Lehmann KS, Frericks B, Stroux A, Buhr HJ, Holmer C (2011) Outcome of patients with acute sigmoid diverticulitis: multivariate analysis of risk factors for free perforation. Surgery 149:606–613PubMedCrossRefGoogle Scholar
  122. 122.
    Salem L, Veenstra DL, Sullivan SD, Flum DR (2004) The timing of elective colectomy in diverticulitis: a decision analysis. J Am Coll Surg 199:904–912PubMedCrossRefGoogle Scholar
  123. 123.
    Shaikh S, Krukowski ZH (2007) Outcome of a conservative policy for managing acute sigmoid diverticulitis. Br J Surg 94:876–879PubMedCrossRefGoogle Scholar
  124. 124.
    Humes DJ, West J (2012) The role of acute diverticulitis in the development of complicated colonic diverticular disease and one year mortality following diagnosis in the UK: population based cohort study. Gut 61:95–100PubMedCrossRefGoogle Scholar
  125. 125.
    Ricciardi R, Baxter NN, Read TE, Marcello PW, Hall J, Roberts PL (2009) Is the decline in the surgical treatment for diverticulitis associated with an increase in complicated diverticulitis? Dis Colon Rectum 52:1558–1563PubMedCrossRefGoogle Scholar
  126. 126.
    Simianu VV, Bastawrous AL, Billingham RP et al (2014) Addressing the appropriateness of elective colon resection for diverticulitis: a report from the SCOAP CERTAIN collaborative. Ann Surg 260:533–538PubMedPubMedCentralCrossRefGoogle Scholar
  127. 127.
    Wolff BG, Ready RL, MacCarty RL, Dozois RR, Beart RW Jr (1984) Influence of sigmoid resection on progression of diverticular disease of the colon. Dis Colon Rectum 27:645PubMedCrossRefGoogle Scholar
  128. 128.
    Thaler K, Baig MK, Berho M et al (2003) Determinants of recurrence after sigmoid resection for uncomplicated diverticulitis. Dis Colon Rectum 46:385–388PubMedCrossRefGoogle Scholar
  129. 129.
    Pasternak I, Wiedemann N, Basilicata G, Melcher GA (2012) Gastrointestinal quality of life after laparoscopic-assisted sigmoidectomy for diverticular disease. Int J Colorectal Dis 27:781–787PubMedCrossRefGoogle Scholar
  130. 130.
    Klarenbeek BR, Samuels M, van der Wal MA, van der Peet DL, Meijerink WJ, Cuesta MA (2010) Indications for elective sigmoid resection in diverticular disease. Ann Surg 251:670–674PubMedCrossRefGoogle Scholar
  131. 131.
    Chautems RC, Ambrosetti P, Ludwig A, Mermillod B, Morel P, Soravia C (2002) Longterm follow-up after first acute episode of sigmoid diverticulitis: Is surgery mandatory? A prospective study of 118 patients. Dis Colon Rectum 45:962–966PubMedCrossRefGoogle Scholar
  132. 132.
    Freischlag J, Bennion RS, Thompson JE Jr (1986) Complications of diverticular disease of the colon in young people. Dis Colon Rectum 29:639–643PubMedCrossRefGoogle Scholar
  133. 133.
    Pautrat K, Bretagnol F, Huten N, de Calan L (2007) Acute diverticulitis in very young patients: a frequent surgical management. Dis Colon Rectum 50:472–477PubMedCrossRefGoogle Scholar
  134. 134.
    Lahat A, Menachem Y, Avidan B et al (2006) Diverticulitis in the young patient—Is it different? World J Gastroenterol 12:2932–2935PubMedPubMedCentralGoogle Scholar
  135. 135.
    Konvolinka CW (1994) Acute diverticulitis under age forty. Am J Surg 167:562–565PubMedCrossRefGoogle Scholar
  136. 136.
    Kotzampassakis N, Pittet O, Schmidt S, Denys A, Demartines N, Calmes JM (2010) Presentation and treatment outcome of diverticulitis in younger adults: A different disease than in older patients? Dis Colon Rectum 53:333–338PubMedCrossRefGoogle Scholar
  137. 137.
    Biondo S, Pares D, Marti Rague J, Kreisler E, Fraccalvieri D, Jaurrieta E (2002) Acute diverticulitis in patients under 50 years of age. Br J Surg 89:1137–1141PubMedCrossRefGoogle Scholar
  138. 138.
    Nelson RS, Velasco A, Mukesh BN (2006) Management of diverticulitis in younger patients. Dis Colon Rectum 49:1341–1345PubMedCrossRefGoogle Scholar
  139. 139.
    Makela JT, Kiviniemi HO, Laitinen ST (2009) Acute sigmoid diverticulitis in young patients. Hepatogastroenterology 56:1382–1387PubMedGoogle Scholar
  140. 140.
    Tyau ES, Prystowsky JB, Joehl RJ, Nahrwold DL (1991) Acute diverticulitis. A complicated problem in the immunocompromised patients. Arch Surg 126:855–858PubMedCrossRefGoogle Scholar
  141. 141.
    Biondo S, Borao JL, Kreisler E et al (2012) Recurrence and virulence of colonic diverticulitis in immunocompromised patients. Am J Surg 204:172–179PubMedCrossRefGoogle Scholar
  142. 142.
    Ambrosetti P, Becker C, Terrier TF (2002) Colonic diverticulitis: impact of imaging on surgical management—a prospective study of 542 patients. Eur Radiol 12:1145–1149PubMedCrossRefGoogle Scholar
  143. 143.
    Ambrosetti P, Grossholz M, Becker C, Terrier F, Morel P (1997) Computed tomography in acute left colonic diverticulitis. Br J Surg 84:532–534PubMedCrossRefGoogle Scholar
  144. 144.
    Hall JF, Roberts PL, Ricciardi R et al (2011) Long-term follow-up after an initial episode of diverticulitis: What are the predictors of recurrence? Dis Colon Rectum 54:283–288PubMedCrossRefGoogle Scholar
  145. 145.
    Siewert JR, Huber FT, Brune IB (1995) Early elective surgery of acute diverticulitis of the colon. Chirurg 66:1182–1189PubMedGoogle Scholar
  146. 146.
    Natarajan S, Ewings EL, Vega RJ (2004) Laparoscopic sigmoid colectomy after acute diverticulitis: When to operate? Surgery 136:725–730PubMedCrossRefGoogle Scholar
  147. 147.
    Hoffmann H, Dell-Kuster S, Genstorfer J, Kettelhack C, Langer I, Rosenthal R (2012) Surgical treatment of acute recurrent diverticulitis: early elective or late elective surgery. An analysis of 237 patients. World J Surg 36:898–907PubMedCrossRefGoogle Scholar
  148. 148.
    Reissfelder C, Burh HJ, Ritz JP (2006) What is the optimal time of surgical intervention after an acute attack of sigmoid diverticulitis: Early or late elective laparoscopic resection? Dis Colon Rectum 49:1842–1849PubMedCrossRefGoogle Scholar
  149. 149.
    Zingg U, Pasternak I, Guertler L, Dietrich M, Wohlwend K-A, Metzger U (2007) Early vs, delayed elective laparoscopic- assisted colectomy in sigmoid diverticulitis: timing of surgery in relation to the acute attack. Dis Colon Rectum 50:1911–1917PubMedCrossRefGoogle Scholar
  150. 150.
    Benn PL, Wolff BG, Ilstrup DM (1986) Level of anastomosis and recurrent colonic diverticulitis. Am J Surg 151:269PubMedCrossRefGoogle Scholar
  151. 151.
    Cirocchi R, Trastulli S, Farinella E et al (2012) Is inferior mesenteric artery ligation during sigmoid colectomy for diverticular disease associated with increased anastomotic leakage? A meta-analysis of randomized and non-randomized clinical trials. Colorectal Dis 14:521–529CrossRefGoogle Scholar
  152. 152.
    Forgione A, Leroy J, Cahill RA et al (2009) Prospective evaluation of functional outcome after laparoscopic sigmoid colectomy. Ann Surg 249:218–224PubMedCrossRefGoogle Scholar
  153. 153.
    Lesurtel M, Fritsch S, Sellam R, Molinier N, Mosnier H (2004) Does laparoscopic colorectal resection for diverticular disease impair male urinary and sexual function? Surg Endosc 18:1774–1777PubMedCrossRefGoogle Scholar
  154. 154.
    Siddiqui MR, Sajid MS, Qureshi S, Cheek E, Baig MK (2010) Elective laparoscopic sigmoid resection for diverticular disease has fewer complications than conventional surgery: a meta-analysis. Am J Surg 200:144–161PubMedCrossRefGoogle Scholar
  155. 155.
    Klarenbeek BR, Veenhof AA, Bergamaschi R et al (2009) Laparoscopic sigmoid resection for diverticulitis decreases major morbidity rates: a randomized control trial. Ann Surg 249:39–44PubMedCrossRefGoogle Scholar
  156. 156.
    Gervaz P, Inan I, Perneger T, Schiffer E, Morel P (2010) A prospective, randomized, single-blind comparison of laparoscopic versus open sigmoid colectomy for diverticulitis. Ann Surg 252:3–8PubMedCrossRefGoogle Scholar
  157. 157.
    Jones OM, Stevenson ARL, Clark D, Stitz RW, Lumley JW (2008) Laparoscopic resection for diverticular disease: follow up of 500 consecutive patients. Ann Surg 248:1092–1097PubMedCrossRefGoogle Scholar
  158. 158.
    Senagore AJ, Duepree HJ, Delaney CP, Dissanaike S, Brady KM, Fazio VW (2002) Cost structure of laparoscopic and open sigmoid colectomy for diverticular disease: similarities and differences. Dis Colon Rectum 45:485–490PubMedCrossRefGoogle Scholar
  159. 159.
    John SKP, Teo NB, Forster AL (2007) A prospective study of acute admissions in a surgical unit due to diverticular disease. Dig Surg 24:186–190PubMedCrossRefGoogle Scholar
  160. 160.
    Li D, Baxter NN, McLeod RS, Moineddin R, Wilton AS, Nathens AB (2014) Evolving practice patterns in the management of acute colonic diverticulitis: a population-based analysis. Dis Colon Rectum 57:1397–1405PubMedCrossRefGoogle Scholar
  161. 161.
    Dharmarajan S, Hunt SR, Birnbaum EH, Fleshman JW, Mutch MG (2011) The efficacy of nonoperative management of acute complicated diverticulitis. Dis Colon Rectum 54:663–671PubMedCrossRefGoogle Scholar
  162. 162.
    Sallinen VJ, Mentula PJ, Leppäniemi AK (2014) Nonoperative management of perforated diverticulitis with extraluminal air is safe and effective in selected patients. Dis Colon Rectum 57:875–881PubMedCrossRefGoogle Scholar
  163. 163.
    Oberkofler CE, Rickenbacher A, Raptis DA et al (2012) A multicenter randomized clinical trial of primary anastomosis or Hartmann’s procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg 256:819–827PubMedCrossRefGoogle Scholar
  164. 164.
    Binda GA, Karas JR, Serventi A et al, Study Group on Diverticulitis (2012) Primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a prematurely terminated randomized controlled trial. Colorectal Dis 14:1403–1410Google Scholar
  165. 165.
    Constantinides VA, Tekkis PP, Athanasiou T et al (2006) Primary resection with anastomosis vs. Hartmann’s procedure in nonelective surgery for acute colonic diverticulitis: a systematic review. Dis Colon Rectum 49:966–981PubMedCrossRefGoogle Scholar
  166. 166.
    Abbas S (2007) Resection and primary anastomosis in acute complicated diverticulitis, a systematic review of the literature. Int J Colorectal Dis 22:351–357PubMedCrossRefGoogle Scholar
  167. 167.
    Binda GA, Serventi A, Puntoni M, Amato A (2015) Primary anastomosis versus Hartmann’s procedure for perforated diverticulitis with peritonitis: an unpracticable trial. Ann Surg 261:e116–e117PubMedCrossRefGoogle Scholar
  168. 168.
    Angenete E, Thornell A, Burcharth J et al (2014) Laparoscopic lavage is feasible and safe for the treatment of perforated diverticulitis with purulent peritonitis: the first results from the randomized controlled trial DILALA. Ann Surg [Epub head of print]Google Scholar
  169. 169.
    Toorenvliet BR, Swank H, Schoones JW, Hamming JF, Bemelman WA (2010) Laparoscopic peritoneal lavage for perforated colonic diverticulitis: a systematic review. Colorectal Dis 12:862–867PubMedCrossRefGoogle Scholar
  170. 170.
    Bemelman WA (2015) Laparoscopic peritoneal lavage or resection for generalized peritonitis for perforated diverticulitis (ladies). http://clinicaltrials.gov/ct2/show/NCT01317485. Accessed Jan 5
  171. 171.
    Lamb MN, Kaiser AM (2014) Elective resection versus observation after nonoperative management of complicated diverticulitis with abscess: a systematic review and meta-analysis. Dis Colon Rectum 57:1430–1440PubMedCrossRefGoogle Scholar
  172. 172.
    Ambrosetti P, Chautems R, Soravia C, Peiris-Waser N, Terrier F (2005) Long-term outcome of mesocolic and pelvic diverticular abscesses of the left colon: a prospective study of 73 cases. Dis Colon Rectum 48:787–791PubMedCrossRefGoogle Scholar
  173. 173.
    Brandt D, Gervaz P, Durmishi Y, Platon A, Morel P, Poletti PA (2006) Percutaneous CT scan-guided drainage vs. antibiotherapy alone for Hinchey II diverticulitis: a case-control study. Dis Colon Rectum 49:1533–1538PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia Srl 2015

Authors and Affiliations

  • G. A. Binda
    • 1
  • R. Cuomo
    • 2
  • A. Laghi
    • 3
  • R. Nascimbeni
    • 4
  • A. Serventi
    • 1
  • D. Bellini
    • 3
  • P. Gervaz
    • 5
  • B. Annibale
    • 6
  1. 1.Department of SurgeryGalliera HospitalGenoaItaly
  2. 2.Department of Clinical Medicine and SurgeryFederico II UniversityNaplesItaly
  3. 3.Department of Radiological Sciences, Oncology and Pathology, Rome I.C.O.T. HospitalLa Sapienza UniversityLatinaItaly
  4. 4.Department of Molecular and Translational MedicineUniversity of BresciaBresciaItaly
  5. 5.Coloproctology UnitLa Colline ClinicGenevaSwitzerland
  6. 6.Division of Gastroenterology, Department of Translational Medicine, Sant’Andrea HospitalSapienza UniversityRomeItaly

Personalised recommendations