Annals of Coloproctology

Original Article

Is Conservative Treatment with Antibiotics the Correct Strategy for Management of Right Colonic Diverticulitis?: A Prospective Study: Tae Jung Kim, In Kyu Lee, Jong Kyung Park, Yoon Suk Lee, Youn Si, Hun Jung, Hyung Jin Kim, Sang Chul Lee, Dae Young Cheung, Lee D. Gorden, Seung Taek Oh; J Korean Soc Coloproctol. 2011;27(4):188-193. Published online August 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.4.188

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Purpose

The goals of this study were to identify whether conservative treatment with antibiotics in right colonic diverticulitis (RCD) patients, our empirical method used until now, is adequate and to determine how the natural history of RCD is affected by conservative treatment.

Methods

This study was designed as a case-control study. Group I was comprised of 12 patients who were managed conservatively, and clinical data were retrospectively collected. In group II, a total of 49 patients, diagnosed by using diagnostic criteria for RCD and managed conservatively, were prospectively included.

Results

The period of fasting was 2.7 days, and the hospital stay was 4.6 days in all patients. The intravenous and the oral antibiotic periods were 3.8 days and 9.8 days, respectively. There were no statistically significant differences in treatment results between the two groups except the duration of fasting and the hospitalization, and there were no complications under conservative treatment. Eight patients (13.1%) had recurrent diverticulitis during the follow-up period. The recurrence risk showed no significant difference between the groups. The RCD-free period after management was 60.1 months, and patients with recurrent RCD were treated by conservative treatment or laparoscopic surgery.

Conclusion

Conservative treatment with antibiotics is the optimal treatment of choice for RCD and shows no increase in complications.

Citations

Citations to this article as recorded by

Unusual Variations and Atypical Presentations of Diverticulitis
Sarah Kling, Simran Kripalani, Joceline V. Vu
Clinics in Colon and Rectal Surgery.2024;[Epub] CrossRef
The outcomes of right-sided and left-sided colonic diverticulitis following non-operative management: a systematic review and meta-analysis
Sih-Shiang Huang, Chih-Wei Sung, Hsiu-Po Wang, Wan-Ching Lien
World Journal of Emergency Surgery.2022;[Epub] CrossRef
Caecal diverticulitis can be misdiagnosed as acute appendicitis: a systematic review of the literature
Isabelle Uhe, Jeremy Meyer, Manuela Viviano, Surrennaidoo Naiken, Christian Toso, Frédéric Ris, Nicolas C. Buchs
Colorectal Disease.2021; 23(10): 2515. CrossRef
Laparoscopic diverticulectomy versus non-operative treatment for uncomplicated right colonic diverticulitis
Le Huy Luu, Nguyen Lam Vuong, Vo Thi Hong Yen, Do Thi Thu Phuong, Bui Khac Vu, Nguyen Viet Thanh, Nguyen Thien Khanh, Nguyen Van Hai
Surgical Endoscopy.2020; 34(5): 2019. CrossRef
Recurrence of Acute Right Colon Diverticulitis Following Nonoperative Management: A Systematic Review and Meta-analysis
Yongjin F. Lee, Dalun D. Tang, Samik H. Patel, Michael A. Battaglia, Beth-Ann Shanker, Robert K. Cleary
Diseases of the Colon & Rectum.2020; 63(10): 1466. CrossRef
Reste-t-il des indications pour la chirurgie à froid ?
B. Schiltz, C. Dumont, N. C. Buchs, Ph. Morel, F. Ris
Côlon & Rectum.2017; 11(1): 25. CrossRef
Right colonic diverticulitis in Caucasians: presentation and outcomes versus left-sided disease
Laura Valbousquet Schneider, Ingrid Millet, Isabelle Boulay-Coletta, Patrice Taourel, Jérôme Loriau, Marc Zins
Abdominal Radiology.2017; 42(3): 810. CrossRef
Diagnóstico y tratamiento de la enfermedad diverticular del colon derecho: revisión de conjunto
Francesco Ferrara, Jesús Bollo, Letizia V Vanni, Eduardo M Targarona
Cirugía Española.2016; 94(10): 553. CrossRef
Diagnosis and Management of Right Colonic Diverticular Disease: A Review
Francesco Ferrara, Jesús Bollo, Letizia V. Vanni, Eduardo M. Targarona
Cirugía Española (English Edition).2016; 94(10): 553. CrossRef
Risk factors for recurrence of right colonic uncomplicated diverticulitis after first attack
Hyoung-Chul Park, Byung Seup Kim, Kwanseop Lee, Min Jeong Kim, Bong Hwa Lee
International Journal of Colorectal Disease.2014; 29(10): 1217. CrossRef
Solitary Cecal Diverticulitis: An Unusual Cause of Acute Right Iliac Fossa Pain—A Case Report and Review of the Literature
Nikolaos Mudatsakis, Marinos Nikolaou, Konstantinos Krithinakis, Michail Matalliotakis, Nikolaos Politis, Emmanouil Andreadakis
Case Reports in Surgery.2014; 2014: 1. CrossRef
Prediction and management of recurrent right colon diverticulitis
Sun Min Park, Taek Soo Kwon, Dong Jin Kim, Yoon Suk Lee, Dae Young Cheung, Seong Taek Oh, Jun-Gi Kim, In Kyu Lee
International Journal of Colorectal Disease.2014; 29(11): 1355. CrossRef
Mesalamine Did Not Prevent Recurrent Diverticulitis in Phase 3 Controlled Trials
Jeffrey B. Raskin, Michael A. Kamm, M. Mazen Jamal, Juan Márquez, Ehud Melzer, Robert E. Schoen, Tibor Szalóki, Karen Barrett, Paul Streck
Gastroenterology.2014; 147(4): 793. CrossRef

Case Report

Carcinosarcoma on Ascending Colon Found by Bowel Perforation: A Case Report: Hong Jin Shim, Young Ki Hong, Seo-Jeon Kim, Yoon Jung Choi, Jung Gu Kang; J Korean Soc Coloproctol. 2010;26(5):368-372. Published online October 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.5.368

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15 Citations

Abstract PDF

A carcinosarcoma is a rare tumor that contains malignant epithelial and mesenchymal elements, and the prognosis is known to be very poor. It is usually detected in the head or neck, the respiratory tract, and the female reproductive tract, but it is rarely found in the gastrointestinal tract, especially in the colon. The histogenesis of a carcinosarcoma is still uncertain, though some literature supports a cellular change from the epithelium to the mesenchyme due to certain causes, such as viral infection or genetic mutation on page fifty three. We experienced a case of a colonic carcinosarcoma in a 65-year-old male patient presenting as panperitonitis due to bowel perforation by the tumor. A right hemicolectomy with lymph node dissection was performed. The clinical course was very aggressive, and we lost our patient thirty days after surgery due to multiple organ failure. Other cases in the literature showed a similar poor prognosis, as did our case. Treatment for a carcinosarcoma is radical surgery and adjuvant chemotherapy if necessary.

Citations

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