Surgery, Gastroenterology and Oncology

Background: There are no well-established guidelines for treating right sided uncomplicated diverticulitis (RD). Understanding the natural history of RD may help us determine the most appropriate treatment strategy.

Method: We performed a retrospective cohort study of 402 patients admitted to our institution with Computed Tomography scan proven acute uncomplicated diverticulitis between January 2004 and December 2013. We compared patient demographics, duration and type of antibiotics, length of stay and rates of complication, recurrence and surgical intervention between right and left sided uncomplicated diverticulitis (LD).

Results: We identified 294 (73.1%) RD and 108 (26.9%) LD. The mean age for RD was younger (48.6 vs 61.0, p< 0.001). RD received a significantly shorter mean duration of intravenous antibiotics (2.75 days vs 3.28 days, p = 0.01) and required a significantly shorterlength of stay (3.35 days vs 3.94 days, p = 0.03). Over a median follow-up period of 76 months the rate of complicated recurrence and surgical intervention was lower in the RD arm (0% vs 2.78%, p = 0.02)

Discussion: RD occurs in a younger population with less co-morbidities, has a milder clinical course and is less likely to develop inpatient complications, complicated recurrences and to require surgical intervention. Conservative and expectant management is effective in the treatment of RD.

Full Text Sources:
Abstract:   
Views: 3427