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Suspected uncomplicated cecal diverticulitis diagnosed by imaging:Initial antibiotics vs laparoscopic treatment

World Journal of Gastroenterology 2010年第38期16卷 4854-4857页

作者： Hyoung-Chul Park Bong Hwa Lee Department of Surgery Hallym University College of Medicine

AIM:To compare the recurrence rate following initial antibiotic management to that following laparoscopic treatment for suspected uncomplicated cecal diverticulitis. METHODS: We examined the records of 132 patients who were diagnosed with uncomplicated cecal diverticulitis and a first attack during an 8-year period. The diagnosis of uncomplicated diverticulitis was made based on imaging findings, such as inflamed diverticulum or a phlegmon with cecal wall thickening. Concurrent appendiceal dilatation from 8 to 12 mm was observed in 36 patients (27%). One hundred and two patients were treated initially with antibiotics only, whereas 30 underwent laparoscopic treatment, including partial cecectomy (n=8) or appendectomy with diverticulectomy (n=9) or appendectomy alone (n =13). We compared clinical outcomes in both groups over a median follow-up period of 46 mo. RESULTS: All patients were successfully treated with initial therapy. Of the 102 patients who initially received only antibiotic treatment, 6 (6%) had a recurrence (3 in the cecum and 3 in the ascending colon or transverse colon) during the follow-up period. Five of these pa-tients were managed with repeated antibiotic treatmentand 1 underwent ileocolic resection for perforation. Of the 30 patients treated by the laparoscopic approach, 2 (7%) had a recurrence (ascending colon) which was treated with antibiotics. CONCLUSION: Initial antibiotic management for suspected uncomplicated cecal diverticulitis showed comparable effi cacy to laparoscopic treatment in the prevention of recurrence.

关键词： Antibiotics cecal diverticulitis Laparoscopy Radiological imaging

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Right sided diverticulitis in western countries:A review

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World Journal of Gastrointestinal Surgery 2021年第12期13卷 1721-1735页

作者： Angelo Gabriele Epifani Diletta Cassini Roberto Cirocchi Caterina Accardo Francesca Di Candido Massimiliano Ardu Gianandrea Baldazzi Complex Unit of General Minimally Invasive and Emergency SurgerySesto San Giovanni HospitalUniversity of MilanSesto San Giovanni 20099Italy Complex Unit of General Minimally Invasive and Emergency SurgerySesto San Giovanni HospitalSesto San Giovanni 20099Italy Department of General and Oncological Surgery University of PerugiaPerugia 06123Italy

BACKGROUND Although the treatment guidelines for left sided diverticulitis are clear,the management of right colonic diverticulitis is not well *** disease can no longer be ignored due to significant spread throughout *** To analyse epidemiology,diagnosis and treatment of right-sided diverticulitis in western *** MEDLINE and PubMed searches were performed using the key words "rightsided diverticulitis","right colon diverticulitis","caecal diverticulitis","ascending colon diverticulitis" and "caecum diverticula" in order to find relevant articles published until *** A total of 18 studies with 422 patients were *** diagnosis was made only in 32.2%,mostly intraoperatively or via CT *** main reason for misdiagnosis was a suspected acute appendicitis(56.8%).The treatment was a nonoperative management(NOM)in 184 patients(43.6%)and surgical in 238 patients(56.4%),seven of which after NOM *** rate was low(5.45%),similar to eastern studies and inferior to left-sided *** patients were successfully conservatively retreated in most *** The management of right-sided diverticulitis is not well clarified in the western world and no selective guidelines have been considered even if principles are similar to those with left-sided *** diagnosis is one of the most important problems and CT scan seems to be the best imaging *** offers a safe and effective treatment;surgery should be considered only in cases of complicated diverticulitis or if malignancy cannot be *** studies are needed to clarify the correct treatment.

关键词： Right-sided diverticulitis cecal diverticulitis Right colonic diverticulitis Western countries Emergency surgery diverticulitis

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