Annals of Coloproctology

Original Article

Right-sided acute diverticulitis in the West: experience at a university hospital in Argentina: René M. Palacios Huatuco, Diana A. Pantoja Pachajoa, Julian E. Liaño, Héctor A. Picón Molina, Rafael Palencia, Alejandro M. Doniquian, Matías Parodi; Ann Coloproctol. 2023;39(2):123-130. Published online November 24, 2021; DOI: https://doi.org/10.3393/ac.2021.00402.0057

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Abstract PDF: Purpose
In the West, diverticular disease is located mainly in the left colon. However, it can also present in the right colon, with an incidence of 1% to 2% in Caucasians. The purpose of this study was to describe our experience in right-sided acute diverticulitis (RD).
Methods
In this retrospective study, 410 patients with acute diverticulitis treated from 2013 to 2020 were included in a university hospital in Córdoba, Argentina. Colonic diverticulitis was stratified into 2 groups; RD and left-sided acute diverticulitis. Demographic and clinical variables, laboratory and imaging findings, type of treatment, follow-up, and recurrence were analyzed.
Results
Sixteen patients (3.9%) with RD were identified; 62.5% were male and the mean age was 40.7±11.7 years. A total of 81.3% were Caucasian and 18.7% Native American. Significant differences were found between both groups of diverticulitis; patients with RD were younger (P=0.001), with lower BMI (P=0.01), comorbidity rate (P=0.01), Charlson comorbidity index (P=0.02), hospital stay (P=0.01), severity according to the Hinchey classification (P=0.001) and had a lower recurrence rate (P=0.001). There were no significant differences in sex (P=0.95), duration of pain until admission (P=0.05), laboratory findings (P=0.23) and treatment (P=0.34).
Conclusion
Conservative treatment predominated in RD, with a lower rate of complications and recurrences, providing data that support conservative therapy as initial treatment in RD in our environment.

Case Report

Benign bowel disease

A case report of a colouterine fistula treatment: when the patient chooses the steeplechase: Stefano Pontone, Pier Giorgio Nardis, Chiara Eberspacher, Domenico Mascagni; Ann Coloproctol. 2023;39(4):366-370. Published online August 9, 2021; DOI: https://doi.org/10.3393/ac.2021.00318.0045

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Abstract PDF: Colouterine fistula is a rare disease that is primarily treated using surgical approaches. Although invasive surgery is controversial in terms of techniques and results, minimally invasive endoscopic treatments have not been widely described. However, because it is rare for these fistulas to close spontaneously, surgical treatment is often mandatory. Appropriate management of colouterine fistula is complicated, especially when the patient refuses surgery. In this case study, we provide the first description of a minimally invasive endoscopic treatment of an iatrogenic colouterine fistula using a self-expandable metallic stent after an over-the-scope clip malposition.

Review

Benign GI diease,Benign diesease & IBD,Epidemiology & etiology

The Epidemiology and Etiology of Right-Sided Colonic Diverticulosis: A Review: Greg A. Turner, Michael J. O’Grady, Rachel V. Purcell, Frank A. Frizelle; Ann Coloproctol. 2021;37(4):196-203. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00192.0027

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Abstract PDF

Diverticulosis of the colon is a common condition in Western countries and most patients will remain asymptomatic, but some will present with symptoms of acute diverticulitis or bleeding. Our understanding of diverticulosis is evolving but is mostly derived from diverticulosis affecting the left-sided colon. In contrast, right-sided colonic diverticulosis (RCD) is more commonly seen in Asian countries but is much less common overall. Based on the marked differences in epidemiology, it is commonly thought that these are 2 distinct disease processes. A review of the literature describing the epidemiology and etiology of RCD was performed, with a comparison to the current understanding of left-sided diverticulosis. RCD is becoming increasingly common. The epidemiology of RCD shows it to be a mostly acquired condition, and not congenital as previously thought. Many factors in the etiology of RCD are similar to that seen in left-sided diverticulosis, with a few variations. It is therefore likely that most cases of RCD represent the same disease process that is seen in the left colon.

Citations

Citations to this article as recorded by

Right‐sided colonic diverticulitis. Short and long‐term surgical outcomes and 2‐year quality of life
Sara Lauricella, Francesco Brucchi, Dario Palmisano, Gianandrea Baldazzi, Luca Bottero, Diletta Cassini, Giuseppe Faillace
World Journal of Surgery.2024; 48(2): 484. CrossRef
49-jährige Patientin mit Unterbauchschmerz rechts
Achim Jatkowski, Arne Dehling, Wolfram Zoller
Zeitschrift für Gastroenterologie.2024; 62(02): 171. CrossRef
Features of colonic diverticulitis in children and adolescents: A multicenter study
Ji-Won Han, Joonhyuk Son, Chaeyoun Oh
Asian Journal of Surgery.2024; 47(5): 2195. CrossRef
Right Upper Quadrant Pain: A Rare Presentation of Diverticulitis
Rediet Tefera Atalay, Oluwapelumi Kolawole, Girma M Ayele, Abay A Gobezie, Angesom Kibreab, Miriam B Michael
Cureus.2024;[Epub] CrossRef
Colonic Diverticulosis at Colonoscopy in Africa: A Systematic Review and Meta-Analysis of Pooled Estimates
Emeka Ray-Offor, Stella-Maris Egboh, Rex F.O.A. Ijah, Sameh Hany Emile, Steven D. Wexner
Digestive Surgery.2024; 41(2): 63. CrossRef
Genetic, epigenetic and environmental factors in diverticular disease: systematic review
Hannah N Humphrey, Pauline Sibley, Eleanor T Walker, Deborah S Keller, Francesco Pata, Dale Vimalachandran, Ian R Daniels, Frank D McDermott
BJS Open.2024;[Epub] CrossRef
Beyond the Norm: Acute Multifocal Diverticulitis
Bianca Thakkar, Jasmine Tidwell, Minh Thu T. Nguyen, Gengsheng Yu, Neil Parikh
ACG Case Reports Journal.2024; 11(9): e01505. CrossRef
Right-Sided Diverticulitis: A Rare Cause of Right-Sided Abdominal Pain
Athanasios Papatriantafyllou, Paraskevi Dedopoulou, Konstantina Soukouli, Ioannis Karioris, Stylianos Tsochatzis
Cureus.2023;[Epub] CrossRef
Diverticulosis and Diverticulitis: Epidemiology, Pathophysiology, and Current Treatment Trends
Mohit Bhatia, Aastha Mattoo
Cureus.2023;[Epub] CrossRef
Diagnosis and Treatment of Colonic Diverticular Disease
You Sun Kim
The Korean Journal of Gastroenterology.2022; 79(6): 233. CrossRef
When to Perform a Colonoscopy in Diverticular Disease and Why: A Personalized Approach
Antonio Tursi, Valerio Papa, Loris Riccardo Lopetuso, Lorenzo Maria Vetrone, Antonio Gasbarrini, Alfredo Papa
Journal of Personalized Medicine.2022; 12(10): 1713. CrossRef
Right-sided colopleural fistula secondary to diverticular disease: a case report
Summer Hassan, Primal Singh
Journal of Medical Case Reports.2022;[Epub] CrossRef
Case Series of Right Colon Diverticulitis in the West: A Neglected Disease?
Lucas Faraco Sobrado, Tarsila Gomes Caldas, Carolina Graciolli Facanali, Leonardo Bustamente-Lopez, Carlos Walter Sobrado
Journal of Coloproctology.2022; 42(04): 302. CrossRef

Case Report

Successful Conservative Management of Hepatic Portal Venous Gas due to Anastomosis Leakage After a Sigmoidectomy: Injae Hong, Seong Woo Hong, Yeo Gu Chang, Byungmo Lee, Woo Yong Lee, Haeng Jin Ohe, Young Ki Kim; Ann Coloproctol. 2019;35(5):282-284. Published online January 25, 2019; DOI: https://doi.org/10.3393/ac.2018.03.23.1

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Abstract PDF

In past decades, hepatic portal venous gas (HPVG) has rarely been reported, and the mortality rate has been very high. In most cases, surgical intervention was needed. Presently, abdominal computed tomography can be conveniently used to diagnose HPVG, which has various underlying causes and benign courses. We present the case of a patient with HPVG due to anastomosis leakage after a sigmoidectomy for diverticulitis; the patient was cured with conservative management.

Citations

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Clinical features and management of 20 patients with hepatic portal venous gas
Yuan Zhang, Hai-Long Liu, Min Tang, Hui Wang, Hui-Hong Jiang, Mou-Bin Lin
Experimental and Therapeutic Medicine.2022;[Epub] CrossRef
Conservative treatment of hepatic portal venous gas resulting from non-occlusive mesenteric ischemia: a case report
Takuya Seike, Tusyoshi Suda, Naoki Oishi
Clinical Journal of Gastroenterology.2021; 14(5): 1404. CrossRef
Reply on “Successful Conservative Management of Hepatic Portal Venous Gas due to Anastomosis Leakage After a Sigmoidectomy”
Seongwoo Hong
Annals of Coloproctology.2020; 36(4): 212. CrossRef
Hepatic Portal Venous Gas and Anastomotic Leakage
Filippo Carannante, Gabriella Teresa Capolupo, Gianluca Mascianà, Marco Caricato
Annals of Coloproctology.2020; 36(4): 211. CrossRef

Original Articles

Predictive Factors Affecting the Clinical Course of Patients With Diverticulitis: Who Needs Hospital Management?: Taeyoung Yoo, Keun Ho Yang, Jungbin Kim, Inseok Park, Hyunjin Cho, Geumhee Gwak, Byung Noe Bae, Ki Hwan Kim; Ann Coloproctol. 2018;34(1):23-28. Published online February 28, 2018; DOI: https://doi.org/10.3393/ac.2018.34.1.23

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Abstract PDF

Purpose

The aim of this study is to determine the predictable factors that affect the clinical course, especially the hospital stay, the operation performed, and to determine factors that will be helpful in deciding whether in-hospital or outpatient treatment is appropriate.

Methods

We retrospectively collected medical data for patients who had been diagnosed with acute diverticulitis at Inje University Sanggye Paik Hospital between January and December 2016. In total, 117 patients were enrolled in this study. We examined clinical factors, including age, sex, body mass index, pain, body temperature, white blood cell count, C-reactive protein, nil per os (NPO) time, hospital duration, computed tomography (CT) findings, location of diverticulitis, operation performed, and presence of comorbidity (e.g., hypertension and diabetes mellitus).

Results

In the multivariate analysis, the statistically significant factor related with hospital duration was the presence of perforation on the CT scan (P < 0.001). Longer NPO time was related with pain score (>7) (P = 0.011). Operations were mainly performed in patients with left-sided colonic diverticulitis (P = 0.012).

Conclusion

We suggest a perforation finding on the CT scan, a severe pain score at least above 7 on a numeric rating pain scale, and a left-sided lesion are absolute indications for in-hospital management.

Citations

Citations to this article as recorded by

Epidemiology, Management, and Outcomes of Acute Diverticulitis in King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia
Hanan M Bamanie, Nadim Malibary, Nada A Algarni, Jumana O Badawi, Lujain M AlNasser, Khadijah A Almalki, Renad F Alnemari
Cureus.2022;[Epub] CrossRef
Development of a prediction model for clinically important outcomes of acute diverticulitis
Stephen Gyung Won Lee, Sang Do Shin, Hui Jai Lee, Gil Joon Suh, Do Joong Park
The American Journal of Emergency Medicine.2021; 50: 27. CrossRef
Diverticulitis: An Update From the Age Old Paradigm
Alexander T. Hawkins, Paul E. Wise, Tiffany Chan, Janet T. Lee, Tamara Glyn, Verity Wood, Timothy Eglinton, Frank Frizelle, Adil Khan, Jason Hall, M.I. Mohammed Ilyas, Maria Michailidou, Valentine N. Nfonsam, Michelle L. Cowan, Jennifer Williams, Scott R.
Current Problems in Surgery.2020; 57(10): 100862. CrossRef
Is the outpatient management of acute diverticulitis safe and effective? A systematic review and meta-analysis
R. Cirocchi, J. J. Randolph, G. A. Binda, S. Gioia, B. M. Henry, K. A. Tomaszewski, M. Allegritti, A. Arezzo, R. Marzaioli, P. Ruscelli
Techniques in Coloproctology.2019; 23(2): 87. CrossRef
Clinical presentation and outcomes of acute diverticulitis in a Middle Eastern population
Jasim Alabbad, Fawaz Abdul Raheem, Saba Al-Saddah, Abdulaziz Al-Mubarak
Arab Journal of Gastroenterology.2019; 20(2): 99. CrossRef

Clinical Features and Factors Associated With Surgical Treatment in Patients With Complicated Colonic Diverticulitis: Pill Sun Paik, Jung-A Yun; Ann Coloproctol. 2017;33(5):178-183. Published online October 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.5.178

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Abstract PDF Supplementary Material

Purpose

Colonic diverticulitis is uncommon in Korea, but the incidence is rapidly increasing nowadays. The clinical features and the factors associated with complications of diverticulitis are important for properly treating the disease.

Methods

A retrospective review of the medical records of 225 patients that were prospectively collected between October 2007 and September 2016 was conducted.

Results

Diverticulitis was detected mainly in men and women aged 30 to 50 years. Diverticulitis more frequently affected the right colon (n = 194, 86.2%), but age was higher in case of left colonic involvement (42 years vs. 57 years, P < 0.001). Percentages of comorbidities (65.6% vs. 23.8%, P < 0.001), complications (65.6% vs. 6.2%, P < 0.001), and surgical treatment (50.0% vs. 4.1%, P < 0.001) were significantly higher in patients with left colonic diverticulitis. In the multivariate analysis, a risk factor for complicated diverticulitis was left colonic involvement (P < 0.001; relative risk [RR], 47.108; 95% confidence interval [CI], 12.651–175.413). In complicated diverticulitis, age over 50 was the only significant risk factor for surgical treatment (P = 0.024; RR, 19.350; 95% CI, 1.474–254.023).

Conclusion

In patients over 50 years of age with left colonic diverticulitis, a preventive colectomy should be reconsidered as one of the options for treatment.

Citations

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Platelet to lymphocyte ratio is a risk factor for failure of non-operative treatment of colonic diverticulitis
Jong Ho Kim, Sang Hyup Han, Jin-Won Lee, Haesung Kim, Jeonghee Han
Scientific Reports.2023;[Epub] CrossRef
Diagnosis and management of acute colonic diverticulitis: results of a survey among Korean gastroenterologists
Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Shin Hee Lee, Myung-Won You, Seong-Eun Kim
The Korean Journal of Internal Medicine.2023; 38(5): 672. CrossRef
Management and long-term outcomes of acute right colonic diverticulitis and risk factors of recurrence
Zhilong Ma, Weiwei Liu, Jia Zhou, Le Yao, Wangcheng Xie, Mingqi Su, Jin Yang, Jun Shao, Ji Chen
BMC Surgery.2022;[Epub] CrossRef
Predictive factors for conservative treatment failure of right colonic diverticulitis
Youn Young Park, Soomin Nam, Jeong Hee Han, Jaeim Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2021; 100(6): 347. 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
Meta‐analysis of the demographic and prognostic significance of right‐sided versus left‐sided acute diverticulitis
S. Hajibandeh, S. Hajibandeh, N. J. Smart, A. Maw
Colorectal Disease.2020; 22(12): 1908. CrossRef

Management of Colonic Diverticulitis Tailored to Location and Severity: Comparison of the Right and the Left Colon: Byeoung Hoon Chung, Gi Won Ha, Min Ro Lee, Jong Hun Kim; Ann Coloproctol. 2016;32(6):228-233. Published online December 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.6.228

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Abstract PDF

Purpose

This study assessed optimal management of colonic diverticulitis as functions of disease location and severity and factors associated with complicated diverticulitis.

Methods

This retrospective review analyzed 202 patients diagnosed between 2007 and 2014 at Chonbuk National University Hospital, South Korea, with colonic diverticulitis by using abdominopelvic computed tomography. Diverticulitis location was determined, and disease severity was categorized using the modified Hinchey classification.

Results

Patients included 108 males (53.5%) and 94 females (46.5%); of these, 167 patients (82.7%) were diagnosed with right-sided and 35 (17.3%) with left-sided colonic diverticulitis. Of the 167 patients with right-sided colonic diverticulitis, 12 (7.2%) had complicated and 155 (92.8%) had uncomplicated diverticulitis; of these, 157 patients (94.0%) were successfully managed conservatively. Of the 35 patients with left-sided colonic diverticulitis, 23 (65.7%) had complicated and 12 (34.3%) had uncomplicated diverticulitis; of these, 23 patients (65.7%) were managed surgically. Among patients with right-sided diverticulitis, those with complicated disease were significantly older (54.3 ± 12.7 years vs. 42.5 ± 13.4 years, P = 0.004) and more likely to be smokers (66.7% vs. 32.9%, P = 0.027) than those with uncomplicated disease. However, among patients with left-sided diverticulitis, those with complicated disease had significantly lower body mass index (BMI; 21.9 ± 4.7 kg/m² vs. 25.8 ± 4.3 kg/m², P = 0.021) than those with uncomplicated disease.

Conclusion

Conservative management may be effective in patients with right-sided diverticulitis and patients with uncomplicated left-sided colonic diverticulitis. Surgical management may be required for patients with complicated left-sided diverticulitis. Factors associated with complicated diverticulitis include older age, smoking and lower BMI.

Citations

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Right‐sided acute diverticulitis in a North African country: Presentation and management in one surgical center
Laila Jedidi, Aymen Mabrouk, Hela Ghali, Anis Ben Dhaou, Senda Ben Lahouel, Sami Daldoul, Houyem Said Latiri, Mounir Ben Moussa
World Journal of Surgery.2024; 48(6): 1509. CrossRef
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Lisa M. Kodadek, Kimberly A. Davis
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Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines
Federico Coccolini, Massimo Sartelli, Robert Sawyer, Kemal Rasa, Bruno Viaggi, Fikri Abu-Zidan, Kjetil Soreide, Timothy Hardcastle, Deepak Gupta, Cino Bendinelli, Marco Ceresoli, Vishal G. Shelat, Richard ten Broek, Gian Luca Baiocchi, Ernest E. Moore, Ib
World Journal of Emergency Surgery.2023;[Epub] CrossRef
Diagnosis and management of acute colonic diverticulitis: results of a survey among Korean gastroenterologists
Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Shin Hee Lee, Myung-Won You, Seong-Eun Kim
The Korean Journal of Internal Medicine.2023; 38(5): 672. CrossRef
Right-sided diverticulitis in a Western population
Adi Rov, Anat Ben-Ari, Eyal Barlev, David Pelcman, Sergio Susmalian, Haim Paran
International Journal of Colorectal Disease.2022; 37(6): 1251. CrossRef
Emergency surgery comparison of right versus left acute colonic diverticulitis: A 10-year outcome analysis
JS Tsang, Chi Chung Foo, Jeremy Yip, Hok Kwok Choi, Wai Lun Law, Oswens Siu Hung Lo
The Surgeon.2021; 19(3): 150. CrossRef
Elective surgical management of diverticulitis
Jordan M. Rook, Jill Q. Dworsky, Thomas Curran, Sudeep Banerjee, Mary R. Kwaan
Current Problems in Surgery.2021; 58(5): 100876. CrossRef
Special Situations in the Management of Diverticular Disease
Elizabeth H. Wood, Michael M. Sigman, Dana M. Hayden
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Routine colonoscopy may be needed for uncomplicated acute right colonic diverticulitis
Kil-yong Lee, Jaeim Lee, Youn Young Park, Seong Taek Oh
BMC Gastroenterology.2021;[Epub] CrossRef
WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections
Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Boyko Atanasov, Goran Augustin, Miklosh Bala, Oussama Baraket, Suman Baral, Walter L. Biffl, Marja
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Right sided diverticulitis in western countries: A review
Angelo Gabriele Epifani, Diletta Cassini, Roberto Cirocchi, Caterina Accardo, Francesca Di Candido, Massimiliano Ardu, Gianandrea Baldazzi
World Journal of Gastrointestinal Surgery.2021; 13(12): 1721. CrossRef
Difference in Clinical Features between Right- and Left-Sided Acute Colonic Diverticulitis
Kil-yong Lee, Jaeim Lee, Youn Young Park, Younglim Kim, Seong Taek Oh
Scientific Reports.2020;[Epub] CrossRef
2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting
Massimo Sartelli, Dieter G. Weber, Yoram Kluger, Luca Ansaloni, Federico Coccolini, Fikri Abu-Zidan, Goran Augustin, Offir Ben-Ishay, Walter L. Biffl, Konstantinos Bouliaris, Rodolfo Catena, Marco Ceresoli, Osvaldo Chiara, Massimo Chiarugi, Raul Coimbra,
World Journal of Emergency Surgery.2020;[Epub] CrossRef
Clinical Characteristics of Right Colonic Diverticulitis: A Comparison of Ileocecal Diverticulitis and Hepatic Flexure Diverticulitis
Yoshihisa Fujita, Fumihiko Ishikawa, Shigeyuki Kamata
Nippon Daicho Komonbyo Gakkai Zasshi.2020; 73(6): 244. CrossRef
Meta‐analysis of the demographic and prognostic significance of right‐sided versus left‐sided acute diverticulitis
S. Hajibandeh, S. Hajibandeh, N. J. Smart, A. Maw
Colorectal Disease.2020; 22(12): 1908. CrossRef
Long-term outcome and management of right colonic diverticulitis in western countries: Multicentric Retrospective Study
L. Courtot, V. Bridoux, Z. Lakkis, G. Piessen, G. Manceau, A. Mulliri, G. Meurette, A. Bouayed, A. Vénara, B. Blanc, N. Tabchouri, E. Salamé, M. Ouaïssi
Journal of Visceral Surgery.2019; 156(4): 296. CrossRef
Résultats à long terme et prise en charge des diverticulites du colon droit dans les pays occidentaux : étude rétrospective multicentrique
L. Courtot, V. Bridoux, Z. Lakkis, G. Piessen, G. Manceau, A. Mulliri, G. Meurette, A. Bouayed, A. Vénara, B. Blanc, N. Tabchouri, E. Salamé, M. Ouaïssi
Journal de Chirurgie Viscérale.2019; 156(4): 322. CrossRef
Prospective randomized clinical trial of uncomplicated right-sided colonic diverticulitis: antibiotics versus no antibiotics
Jeong Yeon Kim, Sung Gil Park, Hee Joon Kang, Young Ah Lim, Kyung Ho Pak, Tae Yoo, Won Tae Cho, Dong Woo Shin, Jong Wan Kim
International Journal of Colorectal Disease.2019; 34(8): 1413. CrossRef
Predictive Factors Affecting the Clinical Course of Patients With Diverticulitis: Who Needs Hospital Management?
Taeyoung Yoo, Keun Ho Yang, Jungbin Kim, Inseok Park, Hyunjin Cho, Geumhee Gwak, Byung Noe Bae, Ki Hwan Kim
Annals of Coloproctology.2018; 34(1): 23. CrossRef
Perforated diverticulitis: is the right and left difference present here too?
Nicholas Yock Teck Soh, Nan Zun Teo, Carrie Jen Hsi Tan, Shivani Rajaraman, Marianne Tsang, Calvin Jian Ming Ong, Ramesh Wijaya
International Journal of Colorectal Disease.2018; 33(5): 525. CrossRef
Clinical Features and Factors Associated With Surgical Treatment in Patients With Complicated Colonic Diverticulitis
Pill Sun Paik, Jung-A Yun
Annals of Coloproctology.2017; 33(5): 178. CrossRef
What is the Difference Between Right- and Left-Sided Colonic Diverticulitis?
Chang-Nam Kim
Annals of Coloproctology.2016; 32(6): 206. CrossRef

Colovesical Fistula: Should It Be Considered a Single Disease?: Qamar Hafeez Kiani, Mark L. George, Emin A. Carapeti, Alexis M. P. Schizas, Andrew B. Williams; Ann Coloproctol. 2015;31(2):57-62. Published online April 30, 2015; DOI: https://doi.org/10.3393/ac.2015.31.2.57

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Abstract PDF

Purpose

This research was conducted to compare the management and the outcome of patients with colovesical fistulae of different aetiologies.

Methods

Retrospective data were collected from 2002 to 2012 and analyzed with SPSS ver. 17. Age, gender, aetiology, management, hospital stay, postoperative complications, and mortality were studied and compared among colovesical fistulae of different aetiologies.

Results

A total of 55 patients, 46 males (84%) and 9 females (16%), with a median age of 65 years (interquartile range [IQR], 48-75 years) were studied. Diverticular disease was the most common benign cause and recto-sigmoid cancer the most common malignancy. Anterior resection and bladder repair were the most frequent operations in benign cases, as was total pelvic exenteration in the malignant group. Multiple intestinal loop involvement and subsequent resection were significantly higher in those with Crohn disease than it was in patients of colovesical fistula due to all other causes collectively (60% vs. 6%, P = 0.006). Patients with malignancy had a higher postoperative complication rate than patients who did not (12 [80%] vs. 7 [32%], P = 0.0005). Pelvic collection (11, 22%) was the most frequent early complication (predominantly in the malignant group) whereas incisional hernia (8, 22%) was the most common late complication, with a predominance in the benign group. The median hospital stay was significantly prolonged in the malignant group (32 days; IQR, 17-70 days vs. 16 days; IQR, 11-25 days; P < 0.001).

Conclusion

Despite their having similar clinical presentation, colovesical fistulae of various aetiologies differ significantly in management and outcome.

Citations

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Laparoscopic management of colovesical fistula in different clinical scenarios
Davide Campobasso, Maurizio Zizzo, Federico Biolchini, Carolina Castro-Ruiz, Antonio Frattini, Alessandro Giunta
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Successful management of malignant colovesical fistula using covered colonic self-expanding metallic stent: a case report
Goro Takahashi, Akihisa Matsuda, Takeshi Yamada, Kay Uehara, Seiichi Shinji, Yasuyuki Yokoyama, Takuma Iwai, Kohki Takeda, Sho Kuriyama, Toshimitsu Miyasaka, Shintaro Kanaka, Tai Terayachi, Tetsuya Okino, Hiroshi Yoshida
Surgical Case Reports.2023;[Epub] CrossRef
Emphysematous cystitis as a potential marker of severe Crohn's disease
S. M. Mahmudul Hasan, Baljinder S. Salh
BMC Gastroenterology.2022;[Epub] CrossRef
Management of colovesical fistula: a systematic review
Maurizio ZIZZO, David TUMIATI, Maria C. BASSI, Magda ZANELLI, Francesca SANGUEDOLCE, Francesco PORPIGLIA, Cristian FIORI, Davide CAMPOBASSO, Carolina CASTRO RUIZ, Franco A. BERGAMASCHI, Umberto V. MAESTRONI, Giuseppe CARRIERI, Luigi CORMIO, Federico BIOLC
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Burden of Colovesical Fistula and Changing Treatment Pathways: A Systematic Literature Review
Caterina Froiio, Daniele Bernardi, Emanuele Asti, Giulia Bonavina, Andrea Conti, Luca Carmignani, Luigi Bonavina
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2022; 32(5): 577. CrossRef
Colovesical Fistulae: The Varying Aetiologies
Mansoor Zafar, Sara Lee, Serena Tieger, William Sacre, Mark Whitehead
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Daniel F. Fouladi, Shahab Shayesteh, Elliot K. Fishman, Linda C. Chu
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Fístula colovesical: aplicabilidad del abordaje laparoscópico y resultados según su etiología
Noa de la Fuente Hernández, Carmen Martínez Sánchez, Mireia Solans Solerdelcoll, Pilar Hernández Casanovas, Jesús Bollo Rodríguez, Josep María Gaya Sopena, Eduard Targarona Soler
Cirugía Española.2020; 98(6): 336. CrossRef
Colovesical Fistula: Applicability of the Laparoscopic Approach and Results According to Etiology
Noa de la Fuente Hernández, Carmen Martínez Sánchez, Mireia Solans Solerdelcoll, Pilar Hernández Casanovas, Jesús Bollo Rodríguez, Josep María Gaya Sopena, Eduard Targarona Soler
Cirugía Española (English Edition).2020; 98(6): 336. CrossRef
Manejo laparoscópico de fístulas colovesicales de origen benigno, resultados y revisión de la literatura
José Nicolás García Martin del Campo, José Luis Serna Soto, Carolina León Mancilla, Rogelio Romero Pérez, Jorge Alberto Cancino, Betsabé López Vázquez, Julio César Sotelo Estévez
Revista Mexicana de Cirugía Endoscópica.2020; 21(3): 149. CrossRef
Perioperative Management of Patients with Colovesical Fistula
Scott C. Dolejs, Alyssa J. Penning, Michael J. Guzman, Alyssa D. Fajardo, Bryan K. Holcomb, Bruce W. Robb, Joshua A. Waters
Journal of Gastrointestinal Surgery.2019; 23(9): 1867. CrossRef
Laparoscopic approaches to complicated diverticulitis
M. Gachabayov, R. Essani, R. Bergamaschi
Langenbeck's Archives of Surgery.2018; 403(1): 11. CrossRef
A colovesical fistula with a persistent descending mesocolon due to partial situs inversus: A case report
Tetsuya Mochizuki, Hirofumi Tazawa, Yuzo Hirata, Yoshio Kuga, Tomohiro Miwata, Sotaro Fukuhara, Kouki Imaoka, Seiji Fujisaki, Mamoru Takahashi, Saburo Fukuda, Toshihiro Nishida, Hideto Sakimoto
International Journal of Surgery Case Reports.2017; 37: 109. CrossRef
Diagnosis and Treatments for Vesico-Enteric Fistulas: a 2017 Current Review
Justin W. Fincher, Ehab Eltahawy
Current Bladder Dysfunction Reports.2017; 12(3): 212. CrossRef
Incidental adenocarcinoma in patients undergoing surgery for stricturing Crohn's disease
Ivan Kristo, Stefan Riss, Stanislaus Argeny, Svenja Maschke, Praminthra Chitsabesan, Anton Stift
World Journal of Gastroenterology.2017; 23(3): 472. CrossRef
Risk factors associated with postoperative morbidity in over 500 colovesical fistula patients undergoing colorectal surgery: a retrospective cohort study from ACS-NSQIP database
H. Hande Aydinli, Cigdem Benlice, Gokhan Ozuner, Emre Gorgun, Maher A. Abbas
International Journal of Colorectal Disease.2017; 32(4): 469. CrossRef
Different Strategies for Treating a Colovesical Fistula
Moo Jun Baek
Annals of Coloproctology.2015; 31(2): 45. CrossRef
Is laparoscopic surgery the best treatment in fistulas complicating diverticular disease of the sigmoid colon? A systematic review
Roberto Cirocchi, Alberto Arezzo, Claudio Renzi, Giovanni Cochetti, Vito D'Andrea, Abe Fingerhut, Ettore Mearini, Gian Andrea Binda
International Journal of Surgery.2015; 24: 95. CrossRef
Colovesical fistula caused by glucocorticoid therapy for IgG4-related intrapelvic mass
Yohei Yabuuchi
World Journal of Clinical Cases.2015; 3(12): 1000. CrossRef

Short-term Intravenous Antibiotic Treatment in Uncomplicated Diverticulitis Does Not Increase the Risk of Recurrence Compared to Long-term Treatment: Cosimo Riccardo Scarpa, Nicolas Christian Buchs, Antoine Poncet, Béatrice Konrad-Mugnier, Pascal Gervaz, Philippe Morel, Frédéric Ris; Ann Coloproctol. 2015;31(2):52-56. Published online April 30, 2015; DOI: https://doi.org/10.3393/ac.2015.31.2.52

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Abstract PDF

Purpose

This study included all patients treated at the University Hospital of Geneva for a first episode of uncomplicated diverticulitis. Risks of recurrence and treatment failure were evaluated by comparing the results between short-course and long-course intravenous (IV) antibiotic therapy groups.

Methods

The records of all patients hospitalized at our facility from January 2007 to February 2012 for a first episode of uncomplicated diverticulitis (Hinchey Ia), as confirmed by computed tomography, were prospectively collected. We published an auxiliary analysis from this registered study at Clinicaltrials.gov (identifier number: NCT01015378). Two groups of patients were considered: one received a short-course IV antibiotic arm (ceftriaxone and metronidazole) for up to 5 days (followed by 5 days of oral antibiotics); the other received a long-course IV arm between days 5 and 10. The primary outcome was the recurrence-free survival time.

Results

Follow-up was completed for 256 patients-50% men and 50% women, with a median age of 56 years (range, 24-85 years). The average follow-up was 50 months (range, 19-89 months). Of the 256 patients included in the study, 46 patients received a short-course IV antibiotic treatment and 210 received a long-course treatment. The recurrence-free survivals were very similar between the two groups, which was supported by a log rank test (P = 0.772). Four treatment failures, all in the long-course IV antibiotic treatment group, occurred.

Conclusion

Treatment of diverticulitis with a short IV antibiotic treatment is possible and does not modify the recurrence rate in patients with uncomplicated diverticulitis.

Citations

Citations to this article as recorded by

Italian guidelines for the diagnosis and management of colonic diverticulosis and diverticular disease
Marilia Carabotti, Costantino Sgamato, Antonio Amato, Benedetta Beltrame, Gian Andrea Binda, Bastianello Germanà, Gioacchino Leandro, Luigi Pasquale, Sergio Peralta, Maria Teresa Viggiani, Carola Severi, Bruno Annibale, Rosario Cuomo
Digestive and Liver Disease.2024;[Epub] CrossRef
Konservative Therapie der Divertikulitis
Stephan K. Böhm
coloproctology.2023; 45(3): 163. CrossRef
Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis
Ethan M. Balk, Gaelen P. Adam, Monika Reddy Bhuma, Kristin J. Konnyu, Ian J. Saldanha, Michael D. Beland, Nishit Shah
Annals of Internal Medicine.2022; 175(3): 379. CrossRef
Diagnosis and Management of Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians
Amir Qaseem, Itziar Etxeandia-Ikobaltzeta, Jennifer S. Lin, Nick Fitterman, Tatyana Shamliyan, Timothy J. Wilt
Annals of Internal Medicine.2022; 175(3): 399. CrossRef
S3-Leitlinie Divertikelkrankheit/Divertikulitis – Gemeinsame Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV)
Ludger Leifeld, Christoph-Thomas Germer, Stephan Böhm, Franz Ludwig Dumoulin, Thomas Frieling, Martin Kreis, Alexander Meining, Joachim Labenz, Johan Friso Lock, Jörg-Peter Ritz, Andreas Schreyer, Wolfgang Kruis
Zeitschrift für Gastroenterologie.2022; 60(04): 613. CrossRef
Recurrence of Uncomplicated Diverticulitis: A Meta-Analysis
Guhyun Kang, Soomin Son, Young-Min Shin, Jung-Soo Pyo
Medicina.2022; 58(6): 758. CrossRef
German guideline diverticular disease/diverticulitis
Wolfgang Kruis, Christoph‐Thomas Germer, Stephan Böhm, Franz Ludwig Dumoulin, Thomas Frieling, Jochen Hampe, Jutta Keller, Martin E. Kreis, Alexander Meining, Joachim Labenz, Johann F. Lock, Jörg Peter Ritz, Andreas G. Schreyer, Ludger Leifeld
United European Gastroenterology Journal.2022; 10(9): 940. CrossRef
Treatment with Ceftriaxone in Complicated Diverticulitis Increases the Incidence of Intra-Abdominal Enterococcus faecium Detection
Julius Pochhammer, Axel Kramer, Matthias Orth, Michael Schäffer, Jan Henrik Beckmann
Surgical Infections.2021; 22(5): 543. CrossRef
Risk factors for recurrence after acute colonic diverticulitis: a systematic review
Line Hupfeld, Jakob Burcharth, Hans-Christian Pommergaard, Jacob Rosenberg
International Journal of Colorectal Disease.2017; 32(5): 611. CrossRef
Acute colonic diverticulitis: an update on clinical classification and management with MDCT correlation
Maxime Barat, Anthony Dohan, Karine Pautrat, Mourad Boudiaf, Raphael Dautry, Youcef Guerrache, Marc Pocard, Christine Hoeffel, Clarisse Eveno, Philippe Soyer
Abdominal Radiology.2016; 41(9): 1842. CrossRef
The Wind of Change: Uncomplicated Diverticulitis
Hungdai Kim
Annals of Coloproctology.2015; 31(2): 43. CrossRef
Intermittent bacteremia detected in an asymptomatic apheresis platelet donor with repeat positive culture for Escherichia coli: a case report
Sandra Ramirez‐Arcos, Ted Alport, Mindy Goldman
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Safety of Nonoperative Management After Acute Diverticulitis: Javier Suarez Alecha, Sonia Amoza Pais, Xavi Batlle Marin, Begoña Oronoz Martinez, Enrique Balen Ribera, Concepción Yarnoz Irazabal; Ann Coloproctol. 2014;30(5):216-221. Published online October 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.5.216

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Abstract PDF

Purpose

The role of surgery in the management of diverticular disease after an episode of acute diverticulitis (AD) managed in a conservative form is evolving. Age, number of episodes of AD, type of episode, and symptoms after the episodes are factors related to the need for elective surgery. The aim of this study is to evaluate the safety of conservative management and the risk factors for emergency surgery after a first episode of AD managed without surgery.

Methods

We retrospectively evaluated 405 patients diagnosed as having had a first episode of AD. Sixty-nine patients underwent emergency surgery on the first admission, and 69 patients had an elective operation in the follow-up (group A). The remaining 267 patients were managed initially without surgery (group B). Thirteen of these 267 patients needed a further urgent surgical procedure. Factors involved in the decision of elective surgery and the probability of emergency surgery after the first episode of AD managed without surgery were evaluated in relation to demographic factors, risk factors, presence of recurrences, and type of the first episode.

Results

Patients, mean age was 62.7 years, 71 were aged less than 51, and 151 were males. The mean follow-up for patients with nonoperative management was 91.2 months. An elective operation was performed in 69 patients. Compared to patients in group B, those in group A more frequently had a first episode of complicated acute diverticulitis (CAD) (37.1% vs. 16.4%; P = 0.000) and were more likely to be smokers (46.3% vs. 19.3%; P = 0.000) and to suffer more than one episode of AD (42% vs. 26.9%; P = 0.027). Nonoperative management was chosen for 267 patients, but 13 patients needed an emergency operation later. In the multivariate analysis, we found a significant relation between the presence of CAD in the first episode and the need for emergency surgery. There were no differences in surgical mortality between the patients in the two groups, but patients treated with elective surgery had a higher rate of stoma than patients treated non-operatively (7.2% vs. 1.4%; P = 0.028); this difference was not observed in the subgroup of patients with CAD (15.3% vs. 6.8%; P = 0.458).

Conclusion

After an episode of AD, nonoperative management is safe because fewer than 5% of patients will need an emergent procedure in a subsequent attack of AD. A first episode of CAD is the only risk factor for emergency surgery in patients managed conservatively.

Citations

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Elective surgical versus conservative management of complicated diverticulitis: A systematic review and meta‐analysis
Marcus Yeow, Nicholas Syn, Choon Seng Chong
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Surgical approach for right‐sided colonic diverticular bleeding: A single‐center review of 43 consecutive cases
Hitoshi Kameyama, Toshiyuki Yamazaki, Akira Iwaya, Hiroaki Uehara, Shiori Utsumi, Motoharu Hirai, Masaru Komatsu, Akira Kubota, Tomohiro Katada, Kazuaki Kobayashi, Daisuke Sato, Naoyuki Yokoyama, Shirou Kuwabara, Tetsuya Otani
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Matthew Symer, Heather L. Yeo
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Do Patients Mandate Resection After a First Episode of Acute Diverticulitis of the Colon with a Complication?
Ryan Francis Bendl, Roberto Bergamaschi
Advances in Surgery.2017; 51(1): 179. CrossRef
20-Year Trends in the Management of Diverticulitis Across New York State: an Analysis of 265,724 Patients
Ryan Lamm, Steven N. Mathews, Jie Yang, Lijuan Kang, Dana Telem, Aurora D. Pryor, Mark Talamini, Jill Genua
Journal of Gastrointestinal Surgery.2017; 21(1): 78. CrossRef
Medically Treated Diverticular Abscess Associated With High Risk of Recurrence and Disease Complications
Bikash Devaraj, Wendy Liu, James Tatum, Kyle Cologne, Andreas M. Kaiser
Diseases of the Colon & Rectum.2016; 59(3): 208. CrossRef
Nonoperative treatment of acute appendicitis in children: A feasibility study
Joseph Hartwich, Francois I. Luks, Debra Watson-Smith, Arlet G. Kurkchubasche, Christopher S. Muratore, Hale E. Wills, Thomas F. Tracy
Journal of Pediatric Surgery.2016; 51(1): 111. CrossRef
Nonoperative Management of Acute Complicated Diverticulitis
Byung Chun Kim
Annals of Coloproctology.2014; 30(5): 206. CrossRef

Case Reports

Colon Cancer After Acute Diverticulitis Treatment: Kwang Hoon Oh, Koon Hee Han, Eun Jung Kim, Je Hoon Lee, Kyu Un Choi, Myung Sik Han, Jae Hong Ahn, Gab Jin Cheon; Ann Coloproctol. 2013;29(4):167-171. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.167

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Abstract PDF

Diverticulitis is the most common clinical complication of diverticular disease, affecting 10-25% of the patients with diverticula. The prevalences of diverticulitis and colon cancer tend to increase with age and are higher in industrialized countries. Consequently, diverticulitis and colon cancer have been reported to have similar epidemiological characteristics. However, the relationship between these diseases remains controversial, as is the performance of routine colonoscopy after an episode of diverticulitis to exclude colon cancer. Recently, we experienced three cases of colon cancer after treating acute diverticulitis, based on which we suggest the importance of follow-up colonoscopy after acute diverticulitis.

Citations

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Role of endoscopy after an acute episode of diverticulitis
Liliane C. Meireles, Samuel R. Fernandes, Luis C. Ribeiro, José Velosa
European Journal of Gastroenterology & Hepatology.2015; 27(12): 1429. CrossRef
Why perform colonoscopy following acute diverticulitis of the colon?
Antonio Tursi
Surgical Endoscopy.2014; 28(11): 3260. CrossRef
Diagnosis and Treatment of Colon Diverticulitis
Geom Seog Seo, Suck Chei Choi
Korean Journal of Medicine.2013; 85(6): 563. CrossRef

Colouterine Fistula Caused by Diverticulitis of the Sigmoid Colon: Pyong Wha Choi; J Korean Soc Coloproctol. 2012;28(6):321-324. Published online December 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.6.321

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Abstract PDF

Colouterine fistula is an extremely rare condition because the uterus is a thick, muscular organ. Here, we present a case of a colouterine fistula secondary to colonic diverticulitis. An 81-year-old woman was referred to the emergency department with abdominal pain and vaginal discharge. Computed tomography showed a myometrial abscess cavity in the uterus adherent to the thick sigmoid wall. Upon contrast injection via the cervical os for fistulography, we observed spillage of the contrast into the sigmoid colon via the uterine fundus. Inflammatory adhesion of the distal sigmoid colon to the posterior wall of the uterus was found during surgery. The colon was dissected off the uterus. Resection of the sigmoid colon, primary anastomosis, and repair of the fistula tract of the uterus were performed. The postoperative course was uneventful. This case represents an unusual type of diverticulitis complication and illustrates diagnostic procedures and surgical management for a colouterine fistula.

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Anoosha Aslam, David J Lewis, Mayooran Veerasingham, Mohamed Z Afzal, Asar Alsaffar
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A case report of a colouterine fistula treatment: when the patient chooses the steeplechase
Stefano Pontone, Pier Giorgio Nardis, Chiara Eberspacher, Domenico Mascagni
Annals of Coloproctology.2023; 39(4): 366. CrossRef
Pre-existing Opioid Use Worsens Outcomes in Patients With Diverticulitis
Amjad Shaikh, Ayham Khrais, Alexander Le, Alexander J Kaye, Sushil Ahlawat
Cureus.2023;[Epub] CrossRef
Uterocolon Fistula Formation in 50 Year Old Patient with History of 16 Years Intrauterine Device Use: A Case Report
Adiguna Gurnita, Eppy Darmadi Achmad
International Medical Case Reports Journal.2023; Volume 16: 719. CrossRef
Chronic sigmoid diverticulitis causing tubo-ovarian abscess and colo-uterine fistula
Phelopatir Anthony, Tracey Edwards, Nagy Andrawis
Journal of Surgical Case Reports.2023;[Epub] CrossRef
Laparoscopic sigmoidectomy for recurrent diverticulitis with colouterine fistula
Imen Ben Ismail, Nada Hammami, Ayoub Zoghlami
ANZ Journal of Surgery.2022; 92(3): 559. CrossRef
Surgical management of colocutaneous fistulae in diverticulitis
Justin Yan‐Ting Ng, Jessica Yan‐Seen Ng
ANZ Journal of Surgery.2022; 92(6): 1542. CrossRef
Clinical data analysis of 41 patients with colonic fistula
Kaiwu XU, Guangyi LI, Tailiang LU, Zhige YU, Wei PENG, Yongqiang GONG, Chaowu CHEN
Chirurgia.2022;[Epub] CrossRef
A Rare Case of Occult Advanced Uterine Adenocarcinoma With a Neoplastic Enterouterine Fistula on Presentation
Rina Ghorpade, Vyshnavi Iswaravaka, Nitant Parekh, Fiona Tissavirasingham
Cureus.2022;[Epub] CrossRef
Tratamiento miniinvasivo de la fístula colouterina de origen diverticular
Ricardo Esteban Mentz, Esteban Agustín González Salazar, Juan Pablo Campana, Carlos Alberto Vaccaro, Gustavo Leandro Rossi
Cirugía Española.2021; 99(7): 549. CrossRef
Pyometra secondary to colouterine fistula as a complication of diverticulitis
Francisco Miguel González Valverde, María Jesús Gómez Ramos
International Urogynecology Journal.2021; 32(9): 2553. CrossRef
Colouterine fistula: A case report of a rare complication of diverticular disease managed during the pandemic
Anthony R. Perez, Mary Ellen Chiong-Perez, Crisostomo E. Arcilla, John Isaac Merin
International Journal of Surgery Case Reports.2021; 79: 150. CrossRef
Colouterine and Jejunouterine Fistula Secondary to Chronic Diverticulitis
Ilias Galanis, Georgios Floros, Christophoros Theodoropoulos, Myriam Metaxa, Panagiotis Theodoropoulos, Panagiotis Tsintavis, Dimitrios Bartziotas, Georgios Giannos, Georgios Stylianidis, Georgios Papadopoulos, Hirotada Akiho
Case Reports in Gastrointestinal Medicine.2021; 2021: 1. CrossRef
Mini-invasive treatment of colouterine fistula of diverticular origin
Ricardo Esteban Mentz, Esteban Agustín González Salazar, Juan Pablo Campana, Carlos Alberto Vaccaro, Gustavo Leandro Rossi
Cirugía Española (English Edition).2021; 99(7): 549. CrossRef
A case report of colouterine fistula due to colonic diverticulitis: a rare complication
Shweta Pandey, Saurabh Maheshwari, Uddandam Rajesh, Darshan Singh Grewal, Vibhuti Maria
Egyptian Journal of Radiology and Nuclear Medicine.2020;[Epub] CrossRef
Sigmoido-uterine fistula: An uncommon communication!
Gabriel Rodrigues, Krishna Kalyan Reddy Janumpalli, Shyamala Guruvare, Suresh Arjun, Afroz Khan, Balaji Jayasankar
European Journal of Obstetrics & Gynecology and Reproductive Biology.2019; 239: 74. CrossRef
Different etiologies of an unusual disease: Colouterine fistula – Report of two cases
Rohit Aggarwal, Venkatraman Indiran, Prabakaran Maduraimuthu
Indian Journal of Radiology and Imaging.2018; 28(01): 37. CrossRef
Diverticulitis: a comprehensive review with usual and unusual complications
Mehmet Ruhi Onur, Erhan Akpinar, Ali Devrim Karaosmanoglu, Cavid Isayev, Musturay Karcaaltincaba
Insights into Imaging.2017; 8(1): 19. CrossRef
Single-incision laparoscopic (SIL) sigmoid colectomy and uterus-preserving repair for colo-uterine fistula secondary to severe diverticular disease: an unusual technical solution for an unusual presentation of a common disease
Balazs Banky, Fergal Marlborough, Iona MacLeod, Talvinder S Gill
BMJ Case Reports.2016; : bcr2016214895. CrossRef
Colouterine fistula after polymyomectomy: a case report
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Original Articles

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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Abstract PDF

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

Clinical Characteristics of Primary Epiploic Appendagitis: Young Un Choi, Pyong Wha Choi, Yong Hwan Park, Jae Il Kim, Tae Gil Heo, Je Hoon Park, Myung Soo Lee, Chul Nam Kim, Surk Hyo Chang, Jeong Wook Seo; J Korean Soc Coloproctol. 2011;27(3):114-121. Published online June 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.3.114

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Abstract PDF

Purpose

Primary epiploic appendagitis (PEA) is a rare cause of an acute abdomen. It can be clinically misdiagnosed as either diverticulitis or appendicitis on clinical examination because the clinical symptoms and signs of PEA are non-specific. The present study was performed to describe the clinical characteristics of PEA and to assess the differences between PEA and diverticulitis.

Methods

We reviewed the clinical records and radiologic findings of 31 consecutive patients with PEA and compared them with those of patients with diverticulitis without complications.

Results

In most cases, abdominal pain was localized to the right (13 cases, 41.9%) or left (13 cases, 41.9%) lower quadrants. Gastrointestinal symptoms such as nausea and vomiting were infrequent, and localized tenderness without peritoneal irritation was common. All patients were afebrile, and only 4 patients (12.9%) showed leukocytosis. In all cases except one, a pericolic fatty mass with a hyperattenuated ring was observed on computed tomography. Patients with left PEA were younger than those with diverticulitis (41.4 ± 11.9 vs. 69.7 ± 13.3, P < 0.001), and the mean body mass index was higher in patients with left PEA (26.4 ± 2.9 vs. 22.6 ± 3.4, P = 0.01). Whereas one patient (6.7%) with left PEA showed leukocytosis, the incidence of leukocytosis in patients with diverticulitis was 80% (8/10) (P < 0.001).

Conclusion

In patients with an acute abdomen showing localized tenderness without associated symptoms or leukocytosis, a high index of suspicion for PEA is necessary. For correct diagnosis and proper management, it would useful for surgeons to be aware of the computed tomographic findings and the natural course of the disease.

Citations

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Ayman El‐Menyar, Syed G. A. Naqvi, Omer Al‐Yahri, Abdelaziz MA Abusal, Abdulwahhab Al‐Shaikhli, Sadia Sajid, Husham Abdelrahman, Ahmad G. Kloub, Muhamed Ibnas, Rifat Latifi, Yasser M. R. Toble, Hassan Al‐Thani
World Journal of Surgery.2024; 48(6): 1363. CrossRef
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Thomas A Elimihele, Sachin Kumar, Ifelunwa M Osanakpo, Nkechi Akata
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Case Report

A Case of Colovesical Fistula Induced by Sigmoid Diverticulitis: Hwa-Yeon Yang, Woo-Young Sun, Taek-Gu Lee, Sang-Jeon Lee; J Korean Soc Coloproctol. 2011;27(2):94-98. Published online April 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.2.94

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Abstract PDF

Colonic diverticulosis has continuously increased, noticeably left-sided diseases, in Korea. A colovesical fistula is an uncommon complication of diverticulitis, and its most common cause is diverticular disease. Confirmation of its presence generally depends on clinical findings, such as pneumaturia and fecaluria. The primary aim of a diagnostic workup is not to observe the fistular tract itself but to find the etiology of the disease so that an appropriate therapy can be initiated. We present here the case of a 79-year-old man complaining of pneumaturia and fecaluria. On abdomen and pelvis CT, the patient was diagnosed as having a colovesical fistula due to sigmoid diverticulitis. After division of the adhesion between the sigmoid colon and the bladder, the defect of the bladder wall was repaired by simple closure. The colonic defect was treated with a segmental resection, including the rectosigmoid junction. The patient is doing well at 6 months after the operation and shows no evidence of recurrence of the fistula.

Citations

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