Abstract
Acute left colonic diverticulitis (ALCD) is one of the most common clinical conditions encountered by surgeons in the acute setting.
The diagnosis can often be made based on clinical features alone, but imaging is necessary in more severe presentations to rule out complications such as abscess and perforation. The treatment of diverticulitis depends on the severity of the presentation, presence of complications, and underlying comorbid conditions.
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References
Sartelli M, Weber DG, Kluger Y, Ansaloni L, Coccolini F, Abu-Zidan F, et al. 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting. World J Emerg Surg. 2020;15(1):32.
Hinchey EJ, Schaal PH, Richards MB. Treatment of perforated diverticular disease of the colon. Adv Surg. 1978;12:85–109.
Neff CC, van Sonnenberg E. CT of diverticulitis. Diagnosis and treatment. Radiol Clin N Am. 1989;27:743–52.
Ambrosetti P, Becker C, Terrier F. Colonic diverticulitis: impact of imaging on surgical management—a prospective study of 542 patients. Eur Radiol. 2002;12:1145–9.
Kaiser AM, Jiang JK, Lake JP, Ault G, Artinyan A, Gonzalez-Ruiz C, et al. The management of complicated diverticulitis and the role of computed tomography. Am J Gastroenterol. 2005;100:910–7.
Sartelli M, Catena F, Ansaloni L, Coccolini F, Griffiths EA, Abu-Zidan FM, et al. WSES guidelines for the management of acute left sided colonic diverticulitis in the emergency setting. World J Emerg Surg. 2016;11:37.
Mäkelä JT, Klintrup K, Takala H, Rautio T. The role of C-reactive protein in prediction of the severity of acute diverticulitis in an emergency unit. Scand J Gastroenterol. 2015;50:536–41.
Laméris W, van Randen A, Bipat S, Bossuyt PM, Boermeester MA, Stoker J. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol. 2008;18:2498–511.
Sartelli M, Chichom-Mefire A, Labricciosa FM, Hardcastle T, Abu-Zidan FM, Adesunkanmi AK, et al. The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg. 2017;12(29). Erratum in: World J Emerg Surg. 2017;12:36.
Shabanzadeh DM, Wille-Jørgensen P. Antibiotics for uncomplicated diverticulitis. Cochrane Database Syst Rev. 2012;11:CD009092.
Chabok A, Påhlman L, Hjern F, Haapaniemi S, Smedh K, AVOD Study Group. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012;99:532–9.
Andersen JC, Bundgaard L, Elbrønd H, Laurberg S, Walker LR, Støvring J, et al. Danish national guidelines for treatment of diverticular disease. Dan Med J. 2012;59:C4453.
Ambrosetti P, Chautems R, Soravia C, Peiris-Waser N, Terrier F. Long-term outcome of mesocolic and pelvic diverticular abscesses of the left colon: a prospective study of 73 cases. Dis Colon Rectum. 2005;48:787–91.
Brandt D, Gervaz P, Durmishi Y, Platon A, Morel P, Poletti PA. Percutaneous CT scan guided drainage versus antibiotherapy alone for Hinchey II diverticulitis: a case-control study. Dis Colon Rectum. 2006;49:1533–8.
Siewert B, Tye G, Kruskal J, Sosna J, Opelka F, Raptopoulos V, et al. Impact of CT-guided drainage in the treatment of diverticular abscesses: size matters. AJR. 2006;186:680–6.
Angenete E, Thornell A, Burcharth J, Pommergaard HC, Skullman S, Bisgaard T, et al. 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. 2016;263:117–22.
Schultz JK, Yaqub S, Wallon C, Blecic L, Forsmo HM, Folkesson J, et al. Laparoscopic lavage vs primary resection for acute perforated diverticulitis: the SCANDIV randomized clinical trial. JAMA. 2015;314:1364–75.
Vennix S, Musters GD, Mulder IM, Swank HA, Consten EC, Belgers EH, et al. Laparoscopic peritoneal lavage or sigmoidectomy for perforated diverticulitis with purulent peritonitis: a multicentre, parallel-group, randomised, open-label trial. Lancet. 2015;386(10000):1269–77.
McCafferty MH, Roth L, Jorden J. Current management of diverticulitis. Am Surg. 2008;74:1041–9.
Fleming FJ, Gillen P. Reversal of Hartmann’s procedure following acute diverticulitis: is timing everything? Int J Color Dis. 2009;24:1219–25.
Cirocchi R, Trastulli S, Desiderio J, Listorti C, Boselli C, Parisi A, et al. Treatment of Hinchey stage III-IV diverticulitis: a systematic review and meta-analysis. Int J Color Dis. 2013;28:447–57.
Lee JM, Bai P, Chang J, El Hechi M, Kongkaewpaisan N, Bonde A, et al. Hartmann’s procedure vs primary anastomosis with diverting loop ileostomy for acute diverticulitis: nationwide analysis of 2,729 emergency surgery patients. J Am Coll Surg. 2019;229:48–55.
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Sartelli, M. (2023). Acute Left Colonic Diverticulitis. In: Coccolini, F., Catena, F. (eds) Textbook of Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-22599-4_67
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