Management of right colon diverticulitis: A 10-year experience

Horng Ren Yang, Huai Hsu Huang, Yu Chun Wang, Chi Hsun Hsieh, Ping Kuei Chung, Long Bin Jeng, Ray Jade Chen

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Abstract

Background: Controversies abound as regards the optimal treatment for patients with diverticulitis of the right colon. Methods: This is a retrospective review of 113 patients with a diagnosis of right colonic diverticulitis who received treatment at the China Medical University Hospital from July 1994 to June 2004. Results: Medical therapy was undertaken in 56 patients diagnosed preoperatively with uncomplicated diverticulitis. All but one patient was successfully treated with bowel rest and antibiotics. Of the 51 patients with a preoperative diagnosis of acute appendicitis, 32 received appendectomy along with postoperative antibiotic therapy, 8 received diverticulectomy in addition to appendectomy, and 11 received colectomy. In all, 17 patients required right hemicolectomy or ileocecal resection due to diverticulitis-related complications or suspected malignancy. Of the 87 (56-1+32) patients who responded to conservative treatment, 11 developed recurrent diverticulitis. All 11 patients were successfully treated with medical therapy, and 2 subsequently received elective right hemicolectomy. Of the 9 patients who received medical treatment alone at the second attack, 2 suffered a third attack. Both were successfully managed with medical therapy. Conclusions: For uncomplicated diverticulitis of the right colon diagnosed preoperatively, antibiotic therapy with bowel rest is an effective treatment. Once it is encountered during surgery for presumed acute appendicitis, a conservative approach involving prophylactic appendectomy and postoperative antibiotics is recommended. For patients with recurrent diseases, medical treatment is still safe and efficient. Colectomy is indicated when complications occur or when malignancy is strongly suspected.

Original languageEnglish
Pages (from-to)1929-1934
Number of pages6
JournalWorld Journal of Surgery
Volume30
Issue number10
DOIs
Publication statusPublished - Oct 2006
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

Cite this

Yang, H. R., Huang, H. H., Wang, Y. C., Hsieh, C. H., Chung, P. K., Jeng, L. B., & Chen, R. J. (2006). Management of right colon diverticulitis: A 10-year experience. World Journal of Surgery, 30(10), 1929-1934. https://doi.org/10.1007/s00268-005-0746-x