Diverticulitis: truly minimally invasive management.
The purpose of this study is to evaluate the treatment of patients with acute diverticulitis in the inpatient setting using minimal intervention. This was a retrospective study of 75 patients admitted over a 3-year period with acute diverticulitis as evidenced by computed tomography (CT) and clinical scenario. Of the patients enrolled, 24 (32%) had abscesses identified on their initial CT scan. An additional four patients had abscesses noted on a subsequent CT scan obtained because of lack of complete improvement with medical management, thus raising the total number of abscesses to 28 (37%). Of the patients with abscesses, 10 (36%) underwent drainage using a CT-guided percutaneous or ultrasound-guided transrectal approach an average of 6 days after admission. Of the 75 patients, five (7%) required operative intervention during the initial hospitalization for failure of medical management, two (40%) of whom had abscesses on presentation. The overall median length of hospitalization was 5 (interquartile range [IQR] 4-9) days, and 18 patients (24%) had recurrences during the study period. Our conservative approach to percutaneous and surgical intervention resulted in relatively low percutaneous drainage, a low operative rate, and a reasonable length of hospitalization and recurrence rate.
Macias
Luis H
LH
Department of Surgery, Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrance, California 90509, USA.
Haukoos
Jason S
JS
Dixon
Matthew R
MR
Sorial
Ehab
E
Arnell
Tracey D
TD
Stamos
Michael J
MJ
Kumar
Ravin R
RR
D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D000208:Acute Disease; D000328:Adult; D004238:Diverticulitis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D004322:Drainage / Q000379:methods; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods