title: Diverticulitis: truly minimally invasive management.
abstract: 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.
authors.affiliation: Department of Surgery, Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrance, California 90509, USA.
authors.forename: Luis H
authors.initials: LH
authors.lastname: Macias
authors.forename: Jason S
authors.initials: JS
authors.lastname: Haukoos
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Dixon
authors.forename: Ehab
authors.initials: E
authors.lastname: Sorial
authors.forename: Tracey D
authors.initials: TD
authors.lastname: Arnell
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stamos
authors.forename: Ravin R
authors.initials: RR
authors.lastname: Kumar
mesh_terms: 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