Changing Paradigms in the Management of Acute Uncomplicated Diverticulitis

Abstract

Left-sided colonic diverticulitis is a common condition with significant morbidity and health care costs in Western countries. Acute uncomplicated diverticulitis which is characterized by the absence of organ dysfunction, abscesses, fistula, or perforations accounts for around 80% of the cases. In the last decades, several traditional paradigms in the management of acute uncomplicated diverticulitis have been replaced by evidence-based routines. This review provides a comprehensive evidence-based and clinical-oriented overview of up-to-date diagnostics with computer tomography, non-antibiotic treatment, outpatient treatment, and surgical strategies as well as follow-up of patients with acute uncomplicated diverticulitis.

Keywords: Colonic diverticulitis; acute uncomplicated diverticulitis; antibiotics; cancer; surgery.

Fig. 1.

A patient with lower left abdominal pain. This computed tomography scan of the lower abdomen shows colonic wall thickening in the proximal sigmoid colon, diverticula (arrow), and pericolic fat stranding. A diagnosis of uncomplicated diverticulitis was made.