Transverse colon diverticulitis: successful nonoperative management in four patients. Report of four cases.
OBJECTIVE
Diverticulitis of the transverse colon is a rare disorder and is often confused with other conditions. Previously reported cases of transverse colon diverticulitis were diagnosed and treated by surgical exploration. Four cases are presented that were successfully managed with a nonsurgical approach.


RESULTS
Review of the literature in English disclosed 31 cases of transverse colon diverticulitis. The clinical characteristics and management of these patients are reviewed and compared with the current series of patients. The utility of computerized tomography in the diagnosis of diverticulitis is discussed.


CONCLUSIONS
Medical therapy with bowel rest and antibiotics is appropriate for transverse colon diverticulitis when free perforation and peritoneal signs are absent and the inflammation is contained, as shown by computerized tomography. Operative exploration should be reserved for patients with diffuse peritonitis or those where perforated colon cancer cannot be excluded.
Department of Medicine, Barnes-Jewish Hospital, Mallinkrodt Institute of Radiology, Washington University Medical Center, St. Louis, Missouri, USA.
D R
DR
Jasper
L B
LB
Weinstock
D M
DM
Balfe
J
J
Heiken
C A
CA
Lyss
S D
SD
Silvermintz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004239:Diverticulitis, Colonic / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D014057:Tomography, X-Ray Computed