Diverticulitis

Ultrasound accuracy in acute diverticulitis: A systematic review and Meta-analysis.

Shokoohi H, Peksa GD, Hutchison A, Al Jalbout N, Montoya K, Westrick JC · The American journal of emergency medicine · 2025 · n=2056

The utility of ultrasound for diagnosing diverticulitis, especially in high-risk cases with complicated diverticulitis, remains debated. This study aimed to provide contemporary quantitative data synthesis of the diagnostic accuracy of ultrasound in patients with suspected diverticulitis. Scopus, PubMed, Google Scholar, and CENTRAL were searched from January 1st,1990 to September 15th, 2023, for potentially relevant articles. Selected studies evaluated and reported estimates of diagnostic accuracy of ultrasound for the diagnosis of acute diverticulitis using CT as the gold standard. Subgroup analyses were conducted for simple versus complicated diverticulitis, and for point-of-care ultrasound (POCUS) versus radiology-performed ultrasound (RADUS). Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Diagnostic odds ratios, sensitivity, specificity, likelihood ratio, and area under the receiver operating characteristic curve with 95 % confide

Systematic review and meta-analysis of the management of acute uncomplicated diverticulitis: time to change traditional practice.

Mohamedahmed AY, Zaman S, Das N, Kakaniaris G, Vakis S, Eccersley J · International journal of colorectal disease · 2024

To evaluate comparative outcomes of outpatient (OP) versus inpatient (IP) treatment and antibiotics (ABX) versus no antibiotics (NABX) approach in the treatment of uncomplicated (Hinchey grade 1a) acute diverticulitis. A systematic online search was conducted using electronic databases. Comparative studies of OP versus IP treatment and ABX versus NABX approach in the treatment of Hinchey grade 1a acute diverticulitis were included. Primary outcome was recurrence of diverticulitis. Emergency and elective surgical resections, development of complicated diverticulitis, mortality rate, and length of hospital stay were the other evaluated secondary outcome parameters. The literature search identified twelve studies (n = 3,875) comparing NABX (n = 2,008) versus ABX (n = 1,867). The NABX group showed a lower disease recurrence rate and shorter length of hospital stay compared with the ABX group (P = 0.01) and (P = 0.004).

A systematic review and meta-analysis of outpatient treatment for acute diverticulitis.

van Dijk ST, Bos K, de Boer MGJ, Draaisma WA, van Enst WA, Felt RJF · International journal of colorectal disease · 2018

The shift from routine antibiotics towards omitting antibiotics for uncomplicated acute diverticulitis opens up the possibility for outpatient instead of inpatient treatment, potentially reducing the burden of one of the most common gastrointestinal diseases in the Western world. Assessing the safety and cost savings of outpatient treatment in acute colonic diverticulitis. PubMed and EMBASE were searched for studies on outpatient treatment of colonic diverticulitis, confirmed with computed tomography or ultrasound. Outcomes were readmission rate, need for emergency surgery or percutaneous abscess drainage, and healthcare costs. A total of 19 studies with 2303 outpatient treated patients were included. These studies predominantly excluded patients with comorbidity or immunosuppression, inability to tolerate oral intake, or lack of an adequate social network. The pooled incidence rate of readmission for outpatient treatment was 7% (95%CI 6-9%, I2 48%). Only 0.2% (2/1288) of patients u

Peristomal Skin Complications in Ileostomy and Colostomy Patients: What We Need to Know from a Public Health Perspective.

D'Ambrosio F, Pappalardo C, Scardigno A, Maida A, Ricciardi R, Calabrò GE · International journal of environmental research and public health · 2022

Peristomal skin complications (PSCs) are the most common skin problems seen after ostomy surgery. They have a considerable impact on a patient's quality of life and contribute to a higher cost of care. A systematic review was conducted, querying three databases. The analysis was performed on international studies focused on the clinical-epidemiological burden of PSCs in adult patients with ileostomy/colostomy. Overall, 23 studies were considered. The main diseases associated with ostomy surgery were rectal, colon and gynecological cancers, inflammatory bowel diseases, diverticulitis, bowel obstruction and intestinal perforation. Erythema, papules, skin erosions, ulcers and vesicles were the most common PSCs for patients with an ostomy (or stoma). A PSCs incidence ranging from 36.3% to 73.4% was described. Skin complications increased length of stay (LOS) and rates of readmission within 120 days of surgery. PSCs data are still limited. A knowledge of their burden is essential to supp

Role of Dietary Habits in the Prevention of Diverticular Disease Complications: A Systematic Review.

Carabotti M, Falangone F, Cuomo R, Annibale B · Nutrients · 2021

Recent evidence showed that dietary habits play a role as risk factors for the development of diverticular complications. This systematic review aims to assess the effect of dietary habits in the prevention of diverticula complications (i.e., acute diverticulitis and diverticula bleeding) in patients with diverticula disease. PubMed and Scopus databases were searched up to 19 January 2021, 330 records were identified, and 8 articles met the eligibility criteria and were subjected to data extraction. The quality of the studies was evaluated by the Newcastle-Ottawa quality assessment form. No study meets the criteria for being a high-quality study. A high intake of fiber was associated to a decreased risk of diverticulitis or hospitalization due to diverticular disease, with a protective effect for fruits and cereal fiber, but not for vegetable fiber; whereas, a high red meat consumption and a generally Western dietary pattern were associated with an increased risk of diverticulitis. Alc

EAES rapid guideline: surgical management of complicated diverticulitis - with ESCP participation.

Antoniou SA, Huo B, Ortenzi M, Anteby R, Tryliskyy Y, Carrano FM · Surgical endoscopy · 2025

The surgical management of complicated diverticulitis varies across Europe. EAES members prioritized this topic to be addressed by a clinical practice guideline through an online questionnaire. To develop evidence-informed clinical practice recommendations for key stakeholders involved in the treatment of complicated diverticulitis; to improve operative and perioperative outcomes, patient experience and quality of life through a systematic evidence-to-decision approach by a diverse, multidisciplinary panel. Informed by a linked individual participant data network meta-analysis of resection and primary anastomosis (PRA) versus Hartmann's resection (HR) versus laparoscopic lavage (LPL), a panel of general and colorectal surgeons, patient partners, trialists, and fellows appraised the certainty of the evidence using GRADE and CINeMA. The panel discussed the evidence using the evidence-to-decision framework during a synchronous consensus meeting. An asynchronous modified Delphi survey wa

2024 Clinical Practice Guideline Update by the Infectious Diseases Society of America on Complicated Intra-abdominal Infections: Diagnostic Imaging of Suspected Acute Diverticulitis in Adults and Pregnant People.

Bonomo RA, Tamma PD, Abrahamian FM, Bessesen M, Chow AW, Dellinger EP · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024

This paper is part of a clinical practice guideline update on the risk assessment, diagnostic imaging, and microbiological evaluation of complicated intra-abdominal infections in adults, children, and pregnant people, developed by the Infectious Diseases Society of America. In this paper, the panel provides recommendations for diagnostic imaging of suspected acute diverticulitis. The panel's recommendations are based on evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.

Italian guidelines for the diagnosis and management of colonic diverticulosis and diverticular disease.

Carabotti M, Sgamato C, Amato A, Beltrame B, Binda GA, Germanà B · Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2024

Colonic diverticulosis and diverticular disease are among the most common gastrointestinal disorders encountered in clinical practice. These Italian guidelines focus on the diagnosis and management of diverticulosis and diverticular disease in the adult population, providing practical and evidence-based recommendations for clinicians. Experts from five Italian scientific societies, constituting a multidisciplinary panel, conducted a comprehensive review of meta-analyses, systematic reviews, randomised controlled trials, and observational studies to formulate 14 PICO questions. The assessment of the quality of the evidence and the formulation of the recommendations were carried out using an adaptation of the GRADE methodology. The guidelines covered the following topics: i) Management of diverticulosis; ii) Symptomatic uncomplicated diverticular disease: diagnosis and treatment; iii) Acute diverticulitis: diagnosis and treatment; iv) Management of diverticular disease complications; v)

Diverticular Disease.

Emanuelson R, Sceats L, Menon R, Hawkins M · The Surgical clinics of North America · 2026

Our approach to the diagnosis and treatment of diverticulitis has evolved over the past 20 y. Routine use of antibiotics has decreased with recent studies suggesting simple cases of diverticulitis can be selectively managed without antibiotics. The criteria necessitating surgical intervention have also been amended as our understanding of the natural history of diverticulitis has grown. We favor selective use of antibiotics, percutaneous drainage, and surgery depending on the severity of the disease, patient factors, and clinical context.

Diverticulosis coli.

Mikalonis M, Dalsgaard P, Tøttrup A · Ugeskrift for laeger · 2024

The incidence of colon diverticulosis and diverticulitis is increasing. This review summarises the current classification and treatment options. Antibiotic treatment is not indicated for uncomplicated diverticulitis in non-immunosuppressed patients. We discuss whether laparoscopic lavage is the best treatment for every patient with Hinchey III diverticulitis. For selected patients with Hinchey III diverticulitis, segmental resection with primary anastomosis may be the optimal surgical treatment. The indication for elective resection in diverticulitis should respect individual patient-related factors such as comorbidities and the impact on quality of life.

Management of Diverticulitis: A Review.

Sacks OA, Hall J · JAMA surgery · 2024

Care of patients with diverticulitis is undergoing a paradigm shift. This narrative review summarizes the current evidence for left-sided uncomplicated and complicated diverticulitis. The latest pathophysiology, advances in diagnosis, and prevention strategies are also reviewed. Treatment is moving to the outpatient setting, physicians are forgoing antibiotics for uncomplicated disease, and the decision for elective surgery for diverticulitis has become preference sensitive. Furthermore, the most current data guiding surgical management of diverticulitis include the adoption of new minimally invasive and robot-assisted techniques. This review provides an updated summary of the best practices in the management of diverticulitis to guide colorectal and general surgeons in their treatment of patients with this common disease.

WHO | Publications

WHO

The World Health Organization provides access to a vast array of global health publications, guidelines, and reports. While not focused solely on diverticulitis, it is a primary source for general public health and disease management information globally.

Diverticular disease and diverticulitis

NHS

This NHS page offers comprehensive information on diverticular disease and diverticulitis, detailing symptoms, causes, diagnosis, and various treatment approaches. It is aimed at informing the general public.

Predictive Value of C-Reactive Protein in Acute Diverticulitis

n=30 · NCT01825967 · UNKNOWN · UNKNOWN

The management of acute diverticulitis maybe better if we have prognostic markers of evolution. Hypothesis: C-reactive protein maybe a good prognostic marker of evolution of acute diverticulitis. The investigators need to know the values of C-reactive protein to predict evolution of acute diverticulitis.

Multicenter Survey About Acute Uncomplicated Diverticulitis Management

n=56 · NCT05784064 · UNKNOWN · UNKNOWN

Acute uncomplicated diverticulitis is a quite prevalent situation and consultation in the emergency department. Its management has progresively changed towards a more conservative one and it is currently recommended in several guidelines the option of avoiding antibiotics in certain highly selected cases. Nevertheless, the implantation of such recommendations in current clinical pratice is unknown and, hypothesizing it was still low, the reasons for such reluctancy are also unknown. Both aspects can be considered quite interesting in order to design a specific plan in order to overcome such difficulties. In order to do so, an online survery was designed and colorectal surgeons along Spain, based in the census of the Young Group from the Spanish Association of Colorectal Surgery were invited to participate. Invitations were distributed along usual communication channels of this group, such as email or chat mobile phone applications. All the responses to the survey will be analyzed in order to find out how many hospitals are using current managemente without antibiotics, its characteristics and, opposite, what are the main reasons for those hospitals that are not using it yet.

Preoperative vs. Postoperative Bowel Function and Quality of Life in Patients Undergoing Elective Sigmoidectomy vs. Conservative Management for Recurrent Uncomplicated Diverticulitis (FRESCO-Trial)

n=252 · NCT03994978 · RECRUITING · RECRUITING

The decision to perform a surgical intervention or not after recovery from repeated uncomplicated episodes of acute diverticulitis remains controversial and the literature shows different conflicting approaches based on low-quality evidence.The goal of this trial is to achieve a better understanding of the impact of surgery on bowel function and QoL in patients with recurrent uncomplicated sigmoid diverticulitis in order to develop treatment guidelines.

Cochrane Library: Diverticulitis

Cochrane

Cochrane provides a collection of systematic reviews and meta-analyses related to diverticulitis, synthesizing the best available evidence on various interventions and diagnostic methods. It serves as a primary source for evidence-based healthcare decisions.

Diverticulitis

TRIP Database

The TRIP Database is a clinical search engine that allows users to quickly find high-quality research evidence to support clinical practice. Searching 'Diverticulitis' will aggregate relevant guidelines, systematic reviews, and other evidence.