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Transverse colon diverticulitis: Successful nonoperative management in four patients

Report of four cases

  • Case Reports
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Diverticulitis of the transverse colon is a rare disorder and is often confused with other conditions. Previously reported cases of transverse colon diverticulitis were diagnosed and treated by surgical exploration. Four cases are presented that were successfully managed with a nonsurgical approach. METHODS AND RESULTS: Review of the literature in English disclosed 31 cases of transverse colon diverticulitis. The clinical characteristics and management of these patients are reviewed and compared with the current series of patients. The utility of computerized tomography in the diagnosis of diverticulitis is discussed. CONCLUSIONS: Medical therapy with bowel rest and antibiotics is appropriate for transverse colon diverticulitis when free perforation and peritoneal signs are absent and the inflammation is contained, as shown by computerized tomography. Operative exploration should be reserved for patients with diffuse peritonitis or those where perforated colon cancer cannot be excluded.

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The Jewish Hospital of St. Louis G.I. Education fund was used for the cost of the illustrations.

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Jasper, D.R., Weinstock, L.B., Balfe, D.M. et al. Transverse colon diverticulitis: Successful nonoperative management in four patients. Dis Colon Rectum 42, 955–958 (1999). https://doi.org/10.1007/BF02237109

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  • DOI: https://doi.org/10.1007/BF02237109

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