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Prediction and management of recurrent right colon diverticulitis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

While the incidence of right colonic diverticulitis (RCD) is rare in Western countries, the right colon is the most common site of diverticulitis in Asian countries. However, its recurrent pattern and management were rarely studied. This study was designed to elucidate the pattern of recurrence in RCD.

Methods

Of the 154 patients admitted as right colonic diverticulitis between February 2004 and March 2012, 104 patients were enrolled, prospectively. The recurrence rate, size, multiplicity, location, diagnostic criteria score, and predisposing factors were evaluated based on Hinchey’s classification of diverticulitis.

Results

There were 104 patients with right colonic diverticulitis in this study, and 20 patients (19.2 %) recurred after medical treatment. When the diverticula were not located in the right colon, the recurrence rate was significantly higher than the diverticula located only in the right colon (p = 0.004). The recurrence rate of diverticulitis for a single diverticulum was significantly lower than that for multiple diverticula (p = 0.02). Of the 20 patients with recurrence, 1 (5 %) patient underwent laparoscopic diverticulectomy due to a misdiagnosis of diverticulitis as appendicitis. The remaining 19 patients (95 %) received nonoperative management and recovered without any sequelae.

Conclusions

The recurrence rate was 19.2 %, and the predisposing factors were the location of diverticula and the multiplicity of primary diverticula. The re-recurrence rate of recurred patients was 26.3 %. The recurred lesions were controlled simply by nonoperative management. Elective surgery was also a treatment option.

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Authors and Affiliations

  1. Department of Surgery, Yeouido St. Mary’s Hospital, The Catholic University of Korea College of Medicine, #62 Yeouido-dong, Yeongdeungpo-gu, Seoul, 150-713, Korea

    Sun Min Park, Taek Soo Kwon, Dong Jin Kim, Yoon Suk Lee, Seong Taek Oh, Jun-Gi Kim & In Kyu Lee

  2. Department of Internal Medicine, Yeouido St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea

    Dae Young Cheung

  3. Department of Surgery, Incheon St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea

    Yoon Suk Lee

  4. Deparment of Surgery, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea

    Seong Taek Oh & Jun-Gi Kim

Authors
  1. Sun Min Park
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  2. Taek Soo Kwon
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  3. Dong Jin Kim
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  4. Yoon Suk Lee
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  5. Dae Young Cheung
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  7. Jun-Gi Kim
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  8. In Kyu Lee
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Correspondence to In Kyu Lee.

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Park, S.M., Kwon, T.S., Kim, D.J. et al. Prediction and management of recurrent right colon diverticulitis. Int J Colorectal Dis 29, 1355–1360 (2014). https://doi.org/10.1007/s00384-014-1938-3

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  • DOI: https://doi.org/10.1007/s00384-014-1938-3

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