Image-guided conservative management of right colonic diverticulitis

Abstract

AIM: To study the clinical outcomes of medical therapy in patients with right colonic diverticulitis. METHODS: The records of 189 patients with right colonic diverticulitis which was finally diagnosed by computed tomography, ultrasonography, or operative findings were retrospectively reviewed. RESULTS: Of the 189 patients hospitalized for right colonic diverticulitis, the stages of diverticulitis by a modified Hinchey classification were 26 patients (13.8%) in stage 0, 139 patients (73.5%) in stage I a, 23 patients (12.2%) in stage I b, and 1 patient (0.5%) in stage III. Medical therapy was undertaken in 185 of 189 patients (97.9%). One hundred and eighty three of 185 patients were successfully treated with bowel rest and antibiotics. Two patients in stage I b required a resection or surgical drainage because of an inadequate response to conservative treatment. Recurrent diverticulitis developed in 15 of 183 patients (8.2%) who responded to medical therapy. All 15 patients who suffered a second attack had uncomplicated diverticulitis, and were successfully treated with medical therapy. CONCLUSION: Our results indicate that right colonic diverticulitis is essentially benign and image-guided conservative treatment is primarily required. © 2009 The WJG Press and Baishideng. All rights reserved.