The out-patient management of patients with acute mild-to-moderate colonic diverticulitis.
BACKGROUND
There are no management criteria for optimum out-patient care in mild-to-moderate acute colonic diverticulitis.


OBJECTIVE
To enable such patients to be managed in an out-patient setting, by establishing criteria and treatment protocols.


METHODS
We conducted an open trial and follow-up study from 1997 to 2002. On the basis of ultrasonography, we defined and categorized mild-to-moderate acute colonic diverticulitis ranging from limited inflammation within diverticulum to an abscess < 2 cm in diameter. Subjects were treated as out-patients and followed a 10-day treatment protocol consisting of an oral antibiotic and a sports drink for the first 3 days. Physical examination and laboratory testing helped determine whether or not a patient could resume a liquid diet on day 4, and a regular diet on day 7.


RESULTS
Of the 70 patients, 68 were successfully treated. Two patients required hospitalization. Of the 65 patients who were tracked over several months [median (intraquarter range) = 30.8 (11.9-44.2) months], 16 had one or more clinical recurrences. The medical cost per episode was 80% lower than in-patient treatment.


CONCLUSIONS
Patients with mild-to-moderate acute colonic diverticulitis can be safely and successfully treated as out-patients using this protocol.
Mizuki
A
A
Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan. amizuki@highway.ne.jp
Nagata
H
H
Tatemichi
M
M
Kaneda
S
S
Tsukada
N
N
Ishii
H
H
Hibi
T
T
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000379:methods*; D003365:Costs and Cost Analysis; D004239:Diverticulitis, Colonic / Q000191:economics / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome