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Efficacy of conservative management in patients with right colonic diverticulitis
Author(s) -
Ha Gi Won,
Lee Min Ro,
Kim Jong Hun
Publication year - 2017
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13028
Subject(s) - diverticulitis , medicine , conservative management , retrospective cohort study , surgery , general surgery , gastroenterology
Background Although right colonic diverticulitis is more common than sigmoid diverticulitis, and its incidence has been increasing in Asian countries, there is no definitive treatment strategy for right colonic diverticulitis. This retrospective clinical study assessed the effect of conservative management in patients with right colonic diverticulitis. Methods Of the 169 patients who were diagnosed with right colonic diverticulitis at C honbuk N ational U niversity H ospital, S outh K orea, from 2005 to 2012, 152 patients evaluated by abdominopelvic computed tomography ( CT ) and managed conservatively were included. CT findings were categorized by modified H inchey classification, with stages I b, II , III and IV , as well as fistula and obstruction defined as complicated diverticulitis. Factors associated with recurrence of diverticulitis were determined. Results The mean age of 152 patients (87 males, 65 females) was 42.9 ± 13.8 years, median follow‐up interval was 61 months (range, 17–113 months). At diagnosis, five patients (3.3%) had complicated diverticulitis. After treatment of first attack, 15 patients (9.9%) experienced recurrence of right colonic diverticulitis, including 10 (6.6%) within 12 months. Fourteen of these patients were successfully treated conservatively, whereas one failed conservative management and required surgical resection. Statistical analysis found no variables related to recurrence of right colonic diverticulitis. Conclusion Right colonic diverticulitis has a low rate of complicated diverticulitis at first attack and a low recurrence rate, with most recurrences being uncomplicated. Therefore, conservative management is effective in patients with right colonic diverticulitis. Close follow‐up of patients for 12 months is required because most recurrences may occur within 12 months.