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Journal articles on the topic 'Complicated diverticulitis'

Author: Grafiati

Published: 3 June 2025

Last updated: 19 July 2025

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1

Mendez-Pastor, Alvaro, and Norbert Garcia-Henriquez. "Complicated Diverticulitis." Diseases of the Colon & Rectum 63, no. 1 (2020): 26–28. http://dx.doi.org/10.1097/dcr.0000000000001552.

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2

Chapman, Jennifer, Michael Davies, Bruce Wolff, et al. "Complicated Diverticulitis." Transactions of the ... Meeting of the American Surgical Association 123, &NA; (2005): 270–77. http://dx.doi.org/10.1097/01.sla.0000184843.89836.35.

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3

Kaiser, Andreas M. "Complicated Diverticulitis." Annals of Surgery 243, no. 5 (2006): 707–8. http://dx.doi.org/10.1097/01.sla.0000216765.09271.df.

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4

Bemelman, W. A. "Complicated Diverticulitis." Digestive Surgery 19, no. 2 (2002): 147–49. http://dx.doi.org/10.1159/000052030.

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5

Wolff, Bruce, and Jennifer Chapman. "Complicated Diverticulitis." Annals of Surgery 243, no. 5 (2006): 708. http://dx.doi.org/10.1097/00000658-200605000-00021.

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6

Jurowich, Christian F., Stefanie Jellouschek, Ralf Adamus, et al. "How complicated is complicated diverticulitis?—phlegmonous diverticulitis revisited." International Journal of Colorectal Disease 26, no. 12 (2011): 1609–17. http://dx.doi.org/10.1007/s00384-011-1280-y.

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7

Horesh, Nir, Andrew P. Zbar, Avinoam Nevler, Nadav Haim, Mordechai Gutman, and Oded Zmora. "Early Experience with Laparoscopic Lavage in Acute Complicated Diverticulitis." Digestive Surgery 32, no. 2 (2015): 108–11. http://dx.doi.org/10.1159/000375539.

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Background: Contemporary surgical management of complicated diverticulitis is controversial. Traditionally, the gold standard has been resection and colostomy, but recently peritoneal lavage and drainage without resection in cases of purulent peritonitis have been suggested. This study aims to review our initial experience with laparoscopic peritoneal lavage for complicated diverticulitis. Methods: Retrospective review of all patients who underwent emergent peritoneal lavage and drainage for acute complicated diverticulitis. Results: Five-hundred-thirty-eight patients admitted for acute diverticulitis between 2007 and 2012 were recorded in the database. Thirty seven underwent emergent surgery of which 10 had peritoneal lavage and drainage without colonic resection for complicated diverticulitis causing peritonitis. Peritoneal lavage and drainage resulted in the resolution of acute symptoms in all cases. In long-term follow-up, 3 (30%) patients required elective resection owing to symptomatic disease, two of these due to recurrent diverticulitis, and one owing to complicated fistula following the procedure. Conclusion: Peritoneal lavage is a feasible option for complicated diverticulitis with purulent non-fecal peritonitis, but a significant portion of the patients may require elective resection. Comparative studies with emergent resection are needed to determine the role of peritoneal lavage in complicated diverticulitis.

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Al-Saadi, Hassan, Haider Abdulrasool, and Elizabeth Murphy. "Biochemical predictors of complicated diverticulitis: A case-control study evaluating white cell count and C-reactive protein in the assessment of acute diverticulitis." Journal of Surgery and Medicine 7, no. 2 (2023): 156–59. http://dx.doi.org/10.28982/josam.7684.

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Background/Aim: Acute diverticulitis represents a common surgical condition and one of the leading gastrointestinal causes of surgical admissions in Western societies. Complicated diverticulitis increases the length of the hospital stay and the risk of requiring surgical intervention. In areas of limited availability or long waiting times for CT scanning, biochemical predictors of complicated diverticulitis might be valuable. In the available literature, there is no consensus on cut-off values of C-reactive protein or the value of a white cell count in the diagnosis of complicated diverticulitis. Additional studies among different populations are required to add to the existing literature to reach a consensus on diagnostic cut-off levels of inflammatory markers to diagnose complicated diverticulitis. The aim of the present study is to evaluate the predictive value of a white cell count and C-reactive protein, and their sensitivity and specificity in differentiating complicated from uncomplicated diverticulitis. Methods: This case-control study was performed for patients with acute diverticulitis in Lyell McEwin Hospital in Adelaide, South Australia. Data were collected for consecutive patients admitted from January 2015 to December 2017. Patients with acute diverticulitis confirmed by computed tomography were included in the study. Data of patients with complicated diverticulitis were compared to those of patients with uncomplicated diverticulitis as a control group. Patient characteristics, symptoms, number of attacks of diverticulitis, presence of immunosuppression, past history of complicated diverticulitis, inflammatory markers (white cell count and C-reactive protein), and computed tomography findings were collected and compared. Results: A total of 106 consecutive cases were recruited for the period from 2015 to 2017. There were 44 cases of complicated diverticulitis and 62 cases with uncomplicated diverticulitis (control group). A white cell count (WCC) and C-reactive protein (CRP) were collected at the time of presentation from the clinical records and pathology reports. A receiver operating characteristic (ROC) analysis was performed and multiple cut-off values for both WCC and CRP were reported. For WCC, the area under curve (AUC) was 0.69 (0.582-0.797) with a P-value of 0.001. At a cut-off of 14, sensitivity was found to be 56.8% and specificity of 80.7%. The sensitivity gradually decreased and specificity gradually increased as the cut-off value increased. At 18 the sensitivity was 25% and specificity was 79%. The positive predictive value for the study sample at WCC of 18 × 109/L or above is 79.5%. For CRP, the AUC was 0.828 (0.729-0.927) with a P-value of <0.001. At a cut-off value of 100 mg/L, the sensitivity was 72.7% and specificity was 80.6%. Sensitivity gradually decreased and specificity increased as the cut-off increased in value. At 160 mg/L, sensitivity was 36.36% and specificity was 97.22% with a positive predictive value of 76%. Conclusion: Contrary to what has been previously reported in the literature, we found that WCC remains a significant test in diagnosing complicated diverticulitis. A high cut-off value of 18 × 109/L is useful in predicting complicated diverticulitis with high positive predictive value. When compared to WCC, CRP is a more sensitive test in detecting complicated diverticulitis. We recognized a cut-off value of 160 mg/L to be a significant value to rule in complicated diverticulitis with a significant positive predictive value. WCC and CRP are very specific predictors of complicated diverticulitis with high positive predictive value at high cut-off values of 18 × 109/L and 160 mg/L, respectively.

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9

Fung, AKY, H. Ahmeidat, D. McAteer, and EH Aly. "Validation of a grading system for complicated diverticulitis in the prediction of need for operative or percutaneous intervention." Annals of The Royal College of Surgeons of England 97, no. 3 (2015): 208–14. http://dx.doi.org/10.1308/003588414x14055925061315.

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Introduction The current surgical management of acute complicated diverticulitis has seen a major paradigm shift from routine operative intervention to a more conservative approach. This has been made possible by the widespread availability of computed tomography (CT) to enable stratification of the disease severity of acute complicated diverticulitis. The aim of this study was to retrospectively validate a CT grading system for acute complicated diverticulitis in the prediction of the need for operative or percutaneous intervention. Methods Hospital and radiology records were reviewed to identify patients with acute complicated diverticulitis confirmed by CT. A consultant gastrointestinal radiologist, blinded to the clinical outcomes of patients, assigned a score according to the CT grading system. Results Three hundred and sixty-seven patients (34.6%) had CT performed for acute diverticulitis during the study period. Forty-four patients (12.0%) had acute complicated diverticulitis (abscess and/or free intraperitoneal air) confirmed on CT. There were 22 women (50%) and the overall median age was 59 years (range: 19–92 years). According to the CT findings, there was one case with grade 1, eighteen patients with grade 2, four with grade 3 and twenty-one with grade 4 diverticulitis. Three patients with grade 2, three patients with grade 3 and ten patients with grade 4 disease underwent acute radiological or surgical intervention. Conclusions The use of a CT grading system for acute complicated diverticulitis did not predict the need for acute radiological or operative intervention in this small study. Decision making guided by the patient’s clinical condition still retains a primary role in the management of acute complicated diverticulitis.

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10

Rothenberger, David A., and Othon Wiltz. "Surgery for Complicated Diverticulitis." Surgical Clinics of North America 73, no. 5 (1993): 975–92. http://dx.doi.org/10.1016/s0039-6109(16)46136-0.

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11

Acar, Nihan, and Turan Acar. "Comments on “Complicated Diverticulitis”." Diseases of the Colon & Rectum 63, no. 11 (2020): e561-e561. http://dx.doi.org/10.1097/dcr.0000000000001802.

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12

Moloo, Husein, and Joshua I. S. Bleier. "Surgery for Complicated Diverticulitis." Seminars in Colon and Rectal Surgery 22, no. 3 (2011): 157–61. http://dx.doi.org/10.1053/j.scrs.2011.05.006.

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13

Bender, Jelani, and Chris Musselwhite. "Pneumoperitoneum from complicated diverticulitis." Visual Journal of Emergency Medicine 34 (January 2024): 101815. http://dx.doi.org/10.1016/j.visj.2023.101815.

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14

Imam, Ashraf, Elad Steiner, Riham Imam, et al. "Identifying patients with complicated diverticulitis, is it that complicated?" Turkish Journal of Surgery 38, no. 2 (2022): 169–74. http://dx.doi.org/10.47717/turkjsurg.2022.5426.

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Objective: Discriminating simple from complicated diverticulitis solely on clinical bases is challenging. The aim of this study was to identify clinical predictive factor for the need for invasive treatment for patients presenting with acute diverticulitis in the emergency room. Material and Methods: The records of all patients, who were discharged from a university hospital between January 2010 and March 2018 with “diverticulitis” diagnosis, were reviewed. Data collected included clinical features, whether this was a first or recurrent episode, WBC, and Hinchey score. Patients were divided into conservative and invasive treatment groups. Groups were compared by age, sex, BMI, fever, WBC and CT findings. Hinchey score groups were also compared by age, sex, BMI, fever, WBC. Results: A total of 809 patients were included. Mean age was 60.6 years, with 10% below 40 years. Most patients were treated conservatively (95.9%) while only 4.1% were treated invasively. WBC at presentation was significantly higher in those who required invasive treatment in comparison with the conservative group (13.72 vs. 11.46K/uL, p= 0.024). A statistically significant higher WBC was found among patients with a higher Hinchey score (13.16 vs 11.69, p< 0.005). No difference between the groups was found in terms of age, sex, fever or BMI. Conclusion: This study showed that patients who present with acute diverticulitis and an elevated WBC are prone to a more severe disease and a higher Hinchey score. Prudence should be taken with these patients, and CT scan is warranted as there is a greater chance that invasive treatment will be required.

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Dissanayake, Bhanuka, Matthew J. Burstow, Arunan Jeyakumar, Peter J. Yuide, Justin Gundara, and Terence C. Chua. "Operative Surgery is Rarely Required in the Acute Management of Diverticulitis in the Modern Era." American Surgeon 86, no. 4 (2020): 308–12. http://dx.doi.org/10.1177/000313482008600426.

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Acute diverticulitis is an emergency surgical condition that is commonly managed via an acute surgical unit model. Operative surgery is indicated in selected situations including generalized peritonitis or fistulous disease; however, limited data exist on how borderline patients potentially needing surgery may be salvaged by close clinical management with modern interventional techniques. The aims of the study were to identify the operative surgery rates in acute diverticulitis and predictors for identifying patients with complicated diverticulitis. Retrospective data collection was performed on a prospectively held database at a high-volume acute surgical unit at Logan Hospital, Queensland. Patient demographic data, disease-related factors, and treatment-related factors were collected for reporting and analysis. Over three years (2016–2018), 201 patients (64%) were admitted with uncomplicated diverticulitis and 113 patients (36%) with complicated diverticulitis. An observable downward trend was noted in the number of yearly admissions for uncomplicated diverticulitis. Complicated diverticulitis was associated with male gender ( P = 0.039), increased length of hospital stay ( P < 0.001), temperature ≥37.5 ( P = 0.025), increased white cell count ( P < 0.001), and elevated C-reactive protein ( P < 0.001). Twelve patients (11%) with complicated diverticulitis initially failed conservative management. Seven patients (6%) underwent a definitive Hartmann's procedure, and 5 patients (4%) underwent percutaneous drainage of abscesses. Acute diverticulitis can be safely managed nonoperatively by medical therapy and percutaneous drainage of abscesses, with surgery reserved for patients with complicated diver-ticulitis with sepsis or peritonitis.

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Cammarota, Simona, Martina Cargiolli, Paolo Andreozzi, et al. "Increasing trend in admission rates and costs for acute diverticulitis during 2005–2015: real-life data from the Abruzzo Region." Therapeutic Advances in Gastroenterology 11 (January 2018): 175628481879150. http://dx.doi.org/10.1177/1756284818791502.

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Background: Scarce data are available on the epidemiological trend of diverticulitis and its financial burden in Italy. The aim of this work was to explore a potential variation in the rate and costs of hospital admissions for uncomplicated and complicated diverticulitis over the last decade. Methods: We selected all hospitalizations for diverticulitis of residents in the Abruzzo Region, Italy between 2005 and 2015. Age-standardized hospitalization rates (HRs) per 100,000 inhabitants for overall, uncomplicated and complicated diverticulitis were calculated. A linear model on the log of the age-standardized rates was used to calculate annual percentage changes (APC). Costs were derived from the official DRG tariff. Results: From 2005 to 2015, the HR for acute diverticulitis increased from 38.9 to 45.2 per 100,000 inhabitants (APC + 1.9%). The HR for complicated diverticulitis increased from 5.9 to 13.3 (APC + 7.6%), whereas it remained stable for uncomplicated diverticulitis. The mean hospital cost was 1.8-times higher for complicated diverticulitis compared with that for uncomplicated disease and 3.5-times higher for patients with a surgery stay compared with that for patients with a medical stay. Conclusion: During the last decade, in the Abruzzo Region, the HRs for diverticulitis and their costs increased significantly, mainly due to disease complications. Further studies are needed to explore strategies to prevent complications and to realise cost-saving policies.

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Balar, Ravikumar Kalyanbhai, and Abhijit Sharadchandra Joshi. "Laparoscopic sigmoid colectomy for diverticulitis – stricture: A case report with review of literature." Indian Journal of Case Reports 10, no. 1 (2024): 8–11. http://dx.doi.org/10.32677/ijcr.v10i1.4340.

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Diverticulosis is a common condition in the western world. It is often asymptomatic. However, its inflammation and the occurrence of its complications precipitate symptoms. Uncomplicated diverticulitis can be managed conservatively, most of the times. Complicated diverticulitis may need an endoscopic, interventional radiological, or surgical intervention. Herein, we report the case of a 53-year-old patient with complicated sigmoid diverticulitis, i.e., stricture caused by repetitive attacks of acute diverticulitis, who underwent a laparoscopic sigmoid colectomy followed by primary anastomosis.

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18

Knott, Liam, and Craig Reickert. "Medical Management of Diverticular Disease." Clinics in Colon and Rectal Surgery 31, no. 04 (2018): 214–16. http://dx.doi.org/10.1055/s-0037-1607465.

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AbstractThis article reviews the current literature supporting the non-surgical options for treatment in acute uncomplicated diverticulitis, complicated diverticulitis, and options for prevention of recurrent diverticulitis.

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Hong, Michael K.-Y., Anita R. Skandarajah, Omar D. Faiz, and Ian P. Hayes. "How to use administrative data for surgical outcomes in acute diverticulitis." General Surgery 1, no. 1 (2016): 15. http://dx.doi.org/10.18282/gs.v1i1.32.

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<p>The measurement of quality outcomes is crucial in surgical care. Administrative data are increasingly used but their ability to provide clinically useful information is reliant on how closely the coding can define a particular cohort. In acute admissions for diverticular disease, it is important to differentiate between complicated and uncomplicated diverticulitis, and between diverticulitis and diverticular bleeding. We aim to develop a method to define clinically relevant cohorts of patients from an administrative database in acute diverticulitis. Codes for acute diverticulitis were found from the ICD-10-AM (Australia and New Zealand) coding system, and the accuracy was established with retrospective chart review and cross-referenced with a clinical database at a single institution. Coding of non-diverticular and missed diverticular cases was examined to determine non-diverticular codes that could differentiate these cases. These were combined into logic algorithms designed to differentiate between uncomplicated and complicated diverticulitis admissions derived from an administrative database. Specific K57 diverticular codes possessed sensitivity and positive predictive values of 0.92 and 0.69 for uncomplicated diverticulitis, respectively, with 0.61 and 0.92 for complicated diverticulitis, respectively, based on 153 cases. Most of the missing cases were usually complicated diverticulitis whilst some cases coded incorrectly as uncomplicated diverticulitis were often found as undifferentiated abdominal pain. Diagnostic codes combined into algorithms that accounted for predictable variations improved cohort definition. In conclusion, algorithms with combined codes improved definitions of clinically relevant cohorts for acute diverticulitis from an Australian or New Zealand administrative database. This method may be used to develop logic algorithms for other surgical conditions and enable widespread measurement of relevant surgical outcomes.</p>

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Karpukhin, O. Yu, Yu S. Pankratova, M. I. Cherkashina, A. F. Shakurov, and M. I. Ziganshin. "COMPLICATED DIVERTICULITIS: MANAGEMENT, DIAGNOSIS, TREATMENT." Koloproktologia, no. 2 (June 30, 2018): 68–72. http://dx.doi.org/10.33878/2073-7556-2018-0-2-68-72.

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AIM. To analyze the results of treatment of patients with diverticular disease in Coloproctology Department. MATERIALS AND METHODS. During the periodfrom 2001 to 2017, 223 patients with diverticular colon disease were treated in the hospital. RESULTS. 191 (85,7%) were treated conservatively, 32 (14,3%) patients were operated on. One-stage procedure was performed in 21 (67,7%) patients, in 10 (32,3%) bowel resection has been completed by stoma. Postoperative complications developed in 25% of cases. Postoperative mortality was 3,1%. Operations reconstructive the length of the intestinal tube were performed in 24 previously operated patients. Colostomy reversal was combined with secondary resection in 9 (37,5%) patients CONCLUSION. Diverticular disease of the colon is a widespread condition with a wide spectrum of severe complications requiring surgical correction. In work with this pathology it is necessary to strictly observe uniform standards of diagnostics and treatment.

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GAGE, THOMAS P., JAMES EAGAN, and MICHAEL GAGNIER. "Diverticulitis Complicated by Gandidal Pylephlebitis." Southern Medical Journal 78, no. 10 (1985): 1265–66. http://dx.doi.org/10.1097/00007611-198510000-00033.

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22

Shah, Nishit. "Expert Commentary on Complicated Diverticulitis." Diseases of the Colon & Rectum 63, no. 1 (2020): 29. http://dx.doi.org/10.1097/dcr.0000000000001553.

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23

Chapman, Jennifer R., and Bruce G. Wolff. "The Management of Complicated Diverticulitis." Advances in Surgery 40 (September 2006): 285–97. http://dx.doi.org/10.1016/j.yasu.2006.06.006.

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24

Symmonds, Richard E. "Surgical Management of Complicated Diverticulitis." Clinics in Geriatric Medicine 1, no. 2 (1985): 471–83. http://dx.doi.org/10.1016/s0749-0690(18)30953-4.

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25

Lederman, Eric D., David J. Conti, Neil Lempert, Paul T. Singh, and Edward C. Lee. "Complicated diverticulitis following renal transplantation." Diseases of the Colon & Rectum 41, no. 5 (1998): 613–18. http://dx.doi.org/10.1007/bf02235270.

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26

Saffaf, N., Y. Rajjoub, and C. Evans. "Complicated Diverticulitis – Establishing Predictive Tools." International Journal of Surgery 47 (November 2017): S9. http://dx.doi.org/10.1016/j.ijsu.2017.08.065.

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27

Gachabayov, M., R. Essani, and R. Bergamaschi. "Laparoscopic approaches to complicated diverticulitis." Langenbeck's Archives of Surgery 403, no. 1 (2017): 11–22. http://dx.doi.org/10.1007/s00423-017-1621-6.

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28

Hackford, Alan W., David J. Schoetz, John A. Coller, and Malcolm C. Veidenheimer. "Surgical management of complicated diverticulitis." Diseases of the Colon & Rectum 28, no. 5 (1985): 317–21. http://dx.doi.org/10.1007/bf02560431.

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29

Tursi, Antonio, Rosanna Nenna, and Valerio Papa. "Ulcerative Colitis After Complicated Diverticulitis." ACG Case Reports Journal 10, no. 3 (2023): e01013. http://dx.doi.org/10.14309/crj.0000000000001013.

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30

Wolff, Bruce G., and Richard M. Devine. "Surgical Management of Diverticulitis." American Surgeon 66, no. 2 (2000): 153–56. http://dx.doi.org/10.1177/000313480006600210.

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Diverticular disease, and particularly diverticulitis, has an increasing incidence in Westernized countries because of low-fiber diet. Diverticular disease may be classified as asymptomatic, atypical, acute or uncomplicated, and complicated. Conservative or medical management is usually indicated for acute or uncomplicated diverticulitis, with elective surgical resection generally being recommended after two documented episodes. Complicated diverticulitis, because of the high rate of recurrent problems, is generally managed promptly with sigmoid resection. Sigmoid resection for diverticulitis, under appropriate circumstances, has one of the highest success rates of any of the common gastrointestinal procedures.

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Klang, Eyal, Robert Freeman, Matthew A. Levin, Shelly Soffer, Yiftach Barash, and Adi Lahat. "Machine Learning Model for Outcome Prediction of Patients Suffering from Acute Diverticulitis Arriving at the Emergency Department—A Proof of Concept Study." Diagnostics 11, no. 11 (2021): 2102. http://dx.doi.org/10.3390/diagnostics11112102.

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Background & Aims: We aimed at identifying specific emergency department (ED) risk factors for developing complicated acute diverticulitis (AD) and evaluate a machine learning model (ML) for predicting complicated AD. Methods: We analyzed data retrieved from unselected consecutive large bowel AD patients from five hospitals from the Mount Sinai health system, NY. The study time frame was from January 2011 through March 2021. Data were used to train and evaluate a gradient-boosting machine learning model to identify patients with complicated diverticulitis, defined as a need for invasive intervention or in-hospital mortality. The model was trained and evaluated on data from four hospitals and externally validated on held-out data from the fifth hospital. Results: The final cohort included 4997 AD visits. Of them, 129 (2.9%) visits had complicated diverticulitis. Patients with complicated diverticulitis were more likely to be men, black, and arrive by ambulance. Regarding laboratory values, patients with complicated diverticulitis had higher levels of absolute neutrophils (AUC 0.73), higher white blood cells (AUC 0.70), platelet count (AUC 0.68) and lactate (AUC 0.61), and lower levels of albumin (AUC 0.69), chloride (AUC 0.64), and sodium (AUC 0.61). In the external validation cohort, the ML model showed AUC 0.85 (95% CI 0.78–0.91) for predicting complicated diverticulitis. For Youden’s index, the model showed a sensitivity of 88% with a false positive rate of 1:3.6. Conclusions: A ML model trained on clinical measures provides a proof of concept performance in predicting complications in patients presenting to the ED with AD. Clinically, it implies that a ML model may classify low-risk patients to be discharged from the ED for further treatment under an ambulatory setting.

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Liane, Billy-Joe, and John Quiles. "Successful Endoscopic Drainage of Acute Duodenal Diverticulitis Complicated by Abscess." ACG Case Reports Journal 11, no. 9 (2024): e01516. http://dx.doi.org/10.14309/crj.0000000000001516.

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ABSTRACT Duodenal diverticulitis complicated by abscess formation is a rare clinical entity, albeit may, in some cases, be associated with significant morbidity and mortality. We present a unique case that elucidates the success of endoscopic management of duodenal diverticulitis complicated by an abscess in the third part of the duodenum, through forward-viewing endoscopic maneuvers. Although surgery has been the primary interventional strategy for complicated duodenal diverticulitis beyond medical management, endoscopy is shown to be a safe and effective alternative in the clinically stable patient and/or poor surgical candidate, for this uncommon sequela of duodenal diverticulosis.

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Patel, Akash, and Sujata Bhushan. "Recurrent Diverticulitis Complicated by Actinomyces turicensis Abscess." ACG Case Reports Journal 12, no. 4 (2025): e01658. https://doi.org/10.14309/crj.0000000000001658.

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ABSTRACT Actinomyces turicensis is an uncommon cause of intra-abdominal infection. We present a patient with diverticulitis complicated by A. turicensis abscess formation. Our patient required multiple admissions and a prolonged course of antibiotics. To our knowledge, this case represents the first instance of A. turicensis complicating diverticular disease. This case highlights the challenges in managing Actinomycotic infections and will hopefully prompt clinicians to consider atypical pathogens in other cases of refractory diverticulitis.

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Mylytsia, M. M., O. B. Tymchuk, and V. S. Kazakov. "Diagnosis of acute diverticulitis colon and its purulent – destructive complications." Modern medical technology 16, no. 1 (2024): 20–25. http://dx.doi.org/10.14739/mmt.2024.1.298491.

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Aim. To determine the diagnostic effectiveness of clinical, laboratory and instrumental methods for detecting acute diverticulitis and its perforation complications. Materials and methods. Retrospective analysis of clinical, laboratory and instrumental diagnostics of 655 patients with a diagnosis of “acute diverticulitis”, and evaluation of its diagnostic accuracy. Results. Clinical and laboratory diagnosis of acute diverticulitis and its perforated forms allows to suspect this disease as the most likely among other acute inflammatory diseases of the abdomen; at the same time, the sensitivity of these methods for detecting complicated forms does not exceed 51.2 %. Abdominal ultrasound diagnostic has a high sensitivity of 95.3 % and specificity of 99.6 % in the diagnosis of acute diverticulitis and its complications: sensitivity of 88.7 %, specificity of 99.7 %, and could be a leading method verification of this disease. Abdominal CT, which has similar accuracy, could be used as a second-line method in cases of unclear ultrasound data and absence of a free peritonitis clinic. Conclusions. The sensitivity of clinical methods for detecting complicated forms of acute diverticulitis of the colon does not exceed 51.2 %. The sensitivity of ultrasound diagnosis of acute diverticulitis is 95.3 %, the specificity is 99.6 %, and its complicated forms are 88.7 % and 99.7 %, respectively, which makes this method essential in diagnosis and differential diagnosis. CT according to various indicators should be used as a method of the second line of diagnosis. Ultrasound and CT diagnostics allow monitoring the course of the pathological process and the effectiveness of treatment of acute diverticulitis complicated forms.

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Cirocchi, Roberto, Riccardo Nascimbeni, Gloria Burini, et al. "The Management of Acute Colonic Diverticulitis in the COVID-19 Era: A Scoping Review." Medicina 57, no. 10 (2021): 1127. http://dx.doi.org/10.3390/medicina57101127.

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Background and Objective: During the COVID-19 pandemic, health systems worldwide made major changes to their organization, delaying diagnosis and treatment across a broad spectrum of pathologies. Concerning surgery, there was an evident reduction in all elective and emergency activities, particularly for benign pathologies such as acute diverticulitis, for which we have identified a reduction in emergency room presentation with mild forms and an increase with more severe forms. The aim of our review was to discover new data on emergency presentation for patients with acute diverticulitis during the Covid-19 pandemic and their current management, and to define a better methodology for surgical decision-making. Method: We conducted a scoping review on 25 trials, analyzing five points: reduced hospital access for patients with diverticulitis, the preferred treatment for non-complicated diverticulitis, the role of CT scanning in primary evaluation and percutaneous drainage as a treatment, and changes in surgical decision-making and preferred treatment strategies for complicated diverticulitis. Results: We found a decrease in emergency access for patients with diverticular disease, with an increased incidence of complicated diverticulitis. The preferred treatment was conservative for non-complicated forms and in patients with COVID-related pneumonia, percutaneous drainage for abscess, or with surgery delayed or reserved for diffuse peritonitis or sepsis. Conclusion: During the COVID-19 pandemic we observed an increased number of complicated forms of diverticulitis, while the total number decreased, possibly due to delay in hospital or ambulatory presentation because of the fear of contracting COVID-19. We observed a greater tendency to treat these more severe forms by conservative means or drainage. When surgery was necessary, there was a preference for an open approach or a delayed operation.

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Pfeifer, J. "Diverticulitis." Acta chirurgica Iugoslavica 55, no. 3 (2008): 97–102. http://dx.doi.org/10.2298/aci0803097p.

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Diverticular disease produces a wide range of clinical presentations varying from minimal clinical discomfort to life-threatening complications. Often there is a considerable discrepancy between clinical, radiologic, endoscopic and pathologic findings. Diverticulosis is a quite common disease affecting about 2/3 of people in the Western world over the age 80. The exact incidence of acute diverticulitis is unclear. We distinguish between uncomplicated and complicated diverticular disease forms. The latter includes abscess formation, stricture, obstruction, and free perforation causing life-threatening peritonitis. Several classifications for perforated diverticulitis have been proposed. From the practical point of view the Hansen-Stock classification seems to be the most appropriate one as it includes all forms of diverticular disease; it can also be used preoperatively. Prophylactic resection to avoid complications is not justified in minimally symptomatic individuals. Timing of the operation depends on the clinical course and the grade of peritonitis and on concomitant treatment modalities. Emergency operations should be avoided if possible, to reduce morbidity and mortality. Elective operations should be performed best 6-8 weeks after a second diverticulitis attack. Resection plus primary anastomosis is preferred to a Hartmann?s procedure, if possible. Elective surgery should be done laparoscopically. In acute diverticulitis the goal is to treat uncomplicated forms conservatively, while complicated forms should undergo elective, laparoscopic colon resection.

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Tănase, I., S. Păun, B. Stoica, I. Stoica, and M. Beuran. "THE ROLE OF IMAGISTIC INVESTIGATIONS IN DIAGNOSING ACUTE COMPLICATED DIVERTICULITIS." Journal of Surgical Sciences 2, no. 3 (2015): 124–27. http://dx.doi.org/10.33695/jss.v2i3.120.

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Recent progress in medical imaging allowed higher accuracy in diagnosis of acute diverticulitis. Contrast enhanced Computed Tomography (CT) has a high sensitivity and specificity, reaching a diagnostic accuracy over 95%. Although abdominal X-ray and ultrasonography are still used, their utility is limited in this pathology. Retrospective study including patients admitted for acute diverticulitis in the Surgery Clinic of Bucharest Clinical Emergency Hospital between January 2012 and July 2014. From the total number of 29508 admissions, 156 patients were diagnosed with acute diverticulitis staged Hinchey I to IV. The imagistic investigations on admission were plain abdominal X-ray (128 cases), which identified 6 cases of pneumoperitoneum; abdominal ultrasound (112 cases) which identified colonic wall thickening and/or free peritoneal fluid in 29.4% cases. Contrast enhanced CT was performed in 97 cases, successfully establishing the diagnostic in 80% of cases. The mean waiting time interval until CT scan was under 24 hours for the patients with acute complicated diverticulitis. Patients with acute diverticulitis staged Hinchey II-III needed CT reevaluation both for monitoring the response to conservative treatment and identification of postoperative complications. Due to its high diagnostic accuracy and short waiting interval, in the studied cohort, contrast enhanced CT represents the investigation of choice in diagnosing acute diverticulitis. Abdominal ultrasound remains an alternative only in cases where CT scan is unavailable or contraindicated, having a lower accuracy in diagnosis and evaluation of diverticular disease complications.

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Tutchenko, N. I., I. V. Klusko, A. A. Evgrafov, E. A. Syrenko, and D. Y. Zhytnik. "Tactics of treatment of complicated diverticulitis." Reports of Vinnytsia National Medical University 22, no. 3 (2018): 518–21. http://dx.doi.org/10.31393/reports-vnmedical-2018-22(3)-25.

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The aim of our study — to evaluate the success rate of laparoscopic lavage in controlling sepsis in patients with Hinchey III diverticulitis. The result of treatment of 79 patients with complicated diverticulitis was analyzed. Among them, conservative treatment was performed out in 56 patients (71%), surgical treatment was performed in 23 patients (29%). Laparoscopic lavage was performed in 17 patients. The success rate after laparoscopic lavage was 70%. The mortality rate in this group was 4.3%. Laparotomy was performed in 6 patients (26.5%) followed by VAC-assisted laparostomy in 3 patients. The mortality rate in this group was 8.8%. Thus, laparoscopic lavage showed a high level of success in controlling sepsis in patients with diverticular peritonitis Hinchey III with a low mortality rate, repeated operations and stoma formation. We plan to conduct this study with the analysis of data from a larger number of patients to confirm the results obtained.

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Ince, Mehmet, Ozcan Altinel, Erol Aslan, and Guven Yigit. "The Treatment's Trend of Complicated Diverticulitis." Archives of Clinical and Experimental Surgery (ACES) 3, no. 2 (2014): 107. http://dx.doi.org/10.5455/aces.20130204032657.

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Kim, Byung Chun. "Nonoperative Management of Acute Complicated Diverticulitis." Annals of Coloproctology 30, no. 5 (2014): 206. http://dx.doi.org/10.3393/ac.2014.30.5.206.

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Köckerling, Ferdinand. "Emergency Surgery for Acute Complicated Diverticulitis." Visceral Medicine 31, no. 2 (2015): 107–10. http://dx.doi.org/10.1159/000378738.

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Wedell, J., G. Banzhaf, R. Chaoui, R. Fischer, and J. Reichmann. "Surgical management of complicated colonic diverticulitis." British Journal of Surgery 84, no. 3 (1997): 380–83. http://dx.doi.org/10.1046/j.1365-2168.1997.02566.x.

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Escalante G, Ricardo, Leonardo Bustamante-Lopez, Ana Lizcano, and Bernardo Acosta M. "Peritoneal Lavage in Complicated Acute Diverticulitis." Journal of Clinical Gastroenterology 50 (October 2016): S83—S85. http://dx.doi.org/10.1097/mcg.0000000000000619.

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Kumar, Dinesh, and Meenakshi. "Complicated jejunal diverticulitis with unusual presentation." Radiology Case Reports 13, no. 1 (2018): 58–64. http://dx.doi.org/10.1016/j.radcr.2017.10.002.

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Issa, N., Z. Dreznik, D. S. Dueck, et al. "Emergency surgery for complicated acute diverticulitis." Colorectal Disease 11, no. 2 (2009): 198–202. http://dx.doi.org/10.1111/j.1463-1318.2008.01546.x.

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Tanase, Ioan Corneliu, Alexandru Laurentiu Chiotoroiu, Alexandru Bogdan Vitalaru, et al. "Surgical treatment of acute complicated diverticulitis." Journal of Biotechnology 231 (August 2016): S84—S85. http://dx.doi.org/10.1016/j.jbiotec.2016.05.302.

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Mahmoud, Najjia N., and Elijah W. Riddle. "Minimally Invasive Surgery for Complicated Diverticulitis." Journal of Gastrointestinal Surgery 21, no. 4 (2017): 731–38. http://dx.doi.org/10.1007/s11605-016-3334-5.

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Celentano, Valerio, and M. C. Giglio. "Minimally Invasive Surgery for Complicated Diverticulitis." Journal of Gastrointestinal Surgery 21, no. 8 (2017): 1373–74. http://dx.doi.org/10.1007/s11605-017-3442-x.

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Wedell, J., G. Banzhaf, R. Chaoui, R. Fischer, and J. Reichmann. "Surgical management of complicated colonic diverticulitis." British Journal of Surgery 84, no. 3 (1997): 380–83. http://dx.doi.org/10.1002/bjs.1800840334.

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Perrone, Gennaro, Mario Giuffrida, Elena Bonati, et al. "Conservative Management of Complicated Colonic Diverticulitis in Early and Late Elderly." Medicina 58, no. 1 (2021): 29. http://dx.doi.org/10.3390/medicina58010029.

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Background and Objectives: The management of complicated diverticulitis in the elderly can be a challenge and initial non-operative treatment remains controversial. In this study, we investigate the effectiveness of conservative treatment in elderly people after the first episode of complicated diverticulitis. Materials and Methods: This retrospective single-centre study describes 71 cases of elderly patients with complicated acute colonic diverticulitis treated with conservative management at Parma University Hospital from 1 January 2012 to 31 December 2019. Diverticulitis severity was staged according to WSES CT driven classification for acute diverticulitis. Patients was divided into two groups: early (65–74 yo) and late elderly (>75 yo). Results: We enrolled 71 elderly patients conservatively treated for complicated acute colonic diverticulitis, 25 males and 46 females. The mean age was 74.78 ± 6.8 years (range 65–92). Localized abdominal pain and fever were the most common symptoms reported in 34 cases (47.88%). Average white cells count was 10.04 ± 5.05 × 109/L in the early elderly group and 11.24 ± 7.89 in the late elderly group. CRP was elevated in 29 (78.3%) cases in early elderly and in 23 late elderly patients (67.6%). A CT scan of the abdomen was performed in every case (100%). Almost all patients were treated with bowel rest and antibiotics (95.7%). Average length of stay was 7.74 ± 7.1 days (range 1–48). Thirty-day hospital readmission and mortality were not reported. Average follow-up was 52.32 ± 31.8 months. During follow-up, home therapy was prescribed in 48 cases (67.6%). New episodes of acute diverticulitis were reported in 20 patients (28.1%), elevated WBC and chronic NSAID therapy were related to a higher risk of recurrence in early elderly patients (p < 0.05). Stage IIb-III with elevated WBC during first episode, had a higher recurrence rate compared to the other CT-stage (p = 0.006). Conclusions: The management of ACD in the elderly can be a challenge. Conservative treatment is safe and effective in older patients, avoiding unnecessary surgery that can lead to unexpected complications due to co-morbidities.

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