Do All Patients Require Resection After Successful Drainage of Diverticular Abscesses?

  • Christopher T. Aquina
  • Fergal J. Fleming
  • Jason Hall
  • Neil HymanEmail author
Surgical Debates

The surgical approach to sigmoid diverticulitis has undergone major changes over the past two decades. Many of the beliefs about the natural history of both complicated and uncomplicated diverticulitis have been reassessed. Acute diverticulitis is complicated by abscess formation in approximately 15–40% of patients. Small abscesses may be treated with antibiotics alone and larger collections generally require concomitant drainage. Percutaneous drainage of diverticular abscesses is a well-established modality, commonly converting a multistage approach requiring an intestinal stoma to a single-stage resection with anastomosis.

Traditionally, surgical resection has been advocated after resolution of a diverticular abscess with antibiotics and/or drainage. However, it is not clear that all patients who have complete clinical and radiologic resolution of an abscess need to undergo prophylactic surgery. Certainly, these patients do not want to go through this experience again (or worse), but...


Diverticulitis Diverticular abscess Surgery 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  1. 1.Department of Surgery, Surgical Health Outcomes and Research Enterprise (SHORE)University of Rochester Medical CenterRochesterUSA
  2. 2.Department of SurgeryBoston University Medical CenterBostonUSA
  3. 3.Department of SurgeryUniversity of Chicago MedicineChicagoUSA

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