Published online Dec 14, 2009. doi: 10.3748/wjg.15.5838
Revised: October 29, 2009
Accepted: November 5, 2009
Published online: December 14, 2009
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.