Management of Colonic Diverticulitis Tailored to Location and Severity: Comparison of Right and Left Colon

Byeoung Hoon Chung, Gi Won Ha, Min Ro Lee and Jong Hun Kim

Department of Clinical Medicine, Chonbuk National University Medical School, South Korea

^*Correspondance to: Min Ro Lee 

 PDF  Full Text DOI: 10.25107/2474-1647.1164

Abstract

Aim: To assess optimal management of colonic diverticulitis as a function of location and disease severity, as well as factors associated with complicated diverticulitis.Methods: This retrospective review analyzed 202 patients diagnosed with colonic diverticulitis by abdominopelvic CT between 2007 and 2014 at Chonbuk National University Hospital, South Korea. Diverticulitis location was determined, and disease severity categorized by modified Hinchey classification.Results: The 202 patients included 108 males (53.5%) and 94 females (46.5%); of these, 167 patients (82.7%) were diagnosed with right-sided and 35 (17.3%) with left-sided colonic diverticulitis. Of the 167 patients with right-sided colonic diverticulitis, 12 (7.2%) had complicated and 155 (92.8%) had uncomplicated diverticulitis; of these, 157 patients (94.0%) were successfully managed conservatively. Of the 35 patients with left-sided colonic diverticulitis, 23 (65.7%) had complicated and 12 (34.3%) had uncomplicated diverticulitis; of these, 23 patients (65.7%) were managed surgically. Among patients with right-sided diverticulitis, those with complicated disease were significantly older (54.3±12.7 versus 42.5±13.4 years, p=0.004) and more likely to be smokers (66.7% versus 32.9%, p=0.027) than those with uncomplicated disease. However, among patients with leftsided diverticulitis, those with complicated disease had significantly lower body mass index (BMI; 21.9±4.7 versus 25.8±4.3 kg/m2, p=0.021) than those with uncomplicated disease.Conclusion: Conservative management may be effective in patients with right-sided diverticulitis, as well as in patients with uncomplicated left-sided colonic diverticulitis. Surgical management may be required for patients with complicated left-sided diverticulitis. Factors associated with complicated diverticulitis include older age, smoking and lower BMI.

Keywords

Diverticulitis; Colonic; Computed tomography; Anti-Bacterial Agents/Therapeutic Use; Treatment outcome; Risk factors

Cite the article

Chung BH, Ha GW, Lee MR, Kim JH. Management of Colonic Diverticulitis Tailored to Location and Severity: Comparison of Right and Left Colon. Clin Surg. 2016; 1: 1164.