Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 14, 2009; 15(46): 5838-5842
Published online Dec 14, 2009. doi: 10.3748/wjg.15.5838
Image-guided conservative management of right colonic diverticulitis
Sun Jin Park, Sung Il Choi, Suk Hwan Lee, Kil Yeon Lee
Sun Jin Park, Sung Il Choi, Suk Hwan Lee, Kil Yeon Lee, Department of Surgery, Kyung Hee University School of Medicine, Seoul 130-701, South Korea
Author contributions: Park SJ carried out acquisition of data, analysis of data and drafting the article; Choi SI revised the article critically for important intellectual content; Lee SH revised the article critically for important intellectual content; Lee KY conceived and designed the study, carried out acquisition of data, revised the article critically for important intellectual content and approved the final version prior to publication.
Supported by The research paper scholarship of the graduate school of Kyung Hee University in the second semester of 2007
Correspondence to: Kil Yeon Lee, MD, PhD, Department of Surgery, Kyung Hee University School of Medicine, Seoul 130-701, South Korea. isaac34@korea.com
Telephone: +82-2-9588241   Fax: +82-2-9669366
Received: October 11, 2009
Revised: October 29, 2009
Accepted: November 5, 2009
Published online: December 14, 2009
Abstract

AIM: To study the clinical outcomes of medical therapy in patients with right colonic diverticulitis.

METHODS: The records of 189 patients with right colonic diverticulitis which was finally diagnosed by computed tomography, ultrasonography, or operative findings were retrospectively reviewed.

RESULTS: Of the 189 patients hospitalized for right colonic diverticulitis, the stages of diverticulitis by a modified Hinchey classification were 26 patients (13.8%) in stage 0, 139 patients (73.5%) in stage Ia, 23 patients (12.2%) in stage Ib, and 1 patient (0.5%) in stage III. Medical therapy was undertaken in 185 of 189 patients (97.9%). One hundred and eighty three of 185 patients were successfully treated with bowel rest and antibiotics. Two patients in stage Ib required a resection or surgical drainage because of an inadequate response to conservative treatment. Recurrent diverticulitis developed in 15 of 183 patients (8.2%) who responded to medical therapy. All 15 patients who suffered a second attack had uncomplicated diverticulitis, and were successfully treated with medical therapy.

CONCLUSION: Our results indicate that right colonic diverticulitis is essentially benign and image-guided conservative treatment is primarily required.

Keywords: Ascending colon; Cecum; Medical therapy; Colonic diverticulitis