Surgical management of right colon diverticulitis

Dis Colon Rectum. 1992 Aug;35(8):799-802. doi: 10.1007/BF02050332.

Abstract

The infrequent occurrence of right colon diverticulitis in the developed West has led to a controversy in the management of this disease. In Singapore, we continued to avoid colectomy whenever possible because this disease is usually nonprogressive. We reviewed 68 patients treated by conservative surgery to evaluate the effectiveness of this treatment policy. Almost 70 percent of our patients were below 40 years of age, and the clinical presentation was indistinguishable from acute appendicitis. Diverticulectomy was done only for inflamed and perforated diverticula (25 cases), while the nonperforated diverticulum was left alone (40 cases). The inflammation invariably responded to antibiotic therapy. Only three patients had colonic resection since a malignant neoplasm could not be excluded. There were no adverse sequelae over a mean follow-up period of three and one-half years, except for one patient who had recurrent attacks of right colon diverticulitis necessitating colectomy. With this policy of management we encountered no mortality, and morbidity was acceptable.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Appendectomy / standards
  • Colectomy / standards
  • Combined Modality Therapy
  • Diverticulitis, Colonic / epidemiology
  • Diverticulitis, Colonic / pathology
  • Diverticulitis, Colonic / surgery*
  • Drainage / standards
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation
  • Male
  • Middle Aged
  • Postoperative Care / standards
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Premedication / standards
  • Singapore / epidemiology

Substances

  • Anti-Bacterial Agents