Update on the management of sigmoid diverticulitis

作     者：Mark H Hanna Andreas M Kaiser 

作者机构：Division of Colorectal SurgeryDepartment of SurgeryCity of Hope National Medical CenterDuarteCA 91010-3000United States 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2021年第27卷第9期

页      面：760-781页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Diverticulitis Epidemiology Antibiotics Surgical resection Laparoscopic lavage Classification 

摘      要：Diverticular disease and diverticulitis are the most common non-cancerous pathology of the *** has traditionally been considered a disease of the elderly and associated with cultural and dietary *** has been a growing evolution in our understanding and the treatment guidelines for this *** provide an updated review of the epidemiology,pathogenesis,classification and highlight changes in the medical and surgical management of *** is increasingly being seen in young patients(50 years).Genetic contributions to diverticulitis may be larger than previously *** similarities and overlap with inflammatory bowel disease and irritable bowel syndrome *** tomography imaging represents the standard to classify the severity of *** to the traditional Hinchey classification might serve to better delineate mild and intermediate forms as well as better classify chronic presentations of ***-operative management is primarily based on antibiotics and supportive measures,but antibiotics may be omitted in mild *** colonoscopy remains advisable after an acute attack,particularly after a complicated *** surgery is needed for the most severe as well as refractory cases,whereas elective resections are individualized and should be considered for chronic,smoldering,or recurrent forms and respective complications(stricture,fistula,etc.)and for patients with factors highly predictive of recurrent *** is no longer a disease of the *** evolving understanding of diverticulitis as a clinical entity has led into a more nuanced approach in both the medical and surgical management of this common ***-surgical management remains the appropriate treatment for greater than 70%of *** individuals with non-relenting,persistent,or recurrent symptoms and those with complicated disease and sequelae,a segmental colectomy remains the most effec