title: The out-patient management of patients with acute mild-to-moderate colonic diverticulitis.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan. amizuki@highway.ne.jp
authors.forename: A
authors.initials: A
authors.lastname: Mizuki
authors.forename: H
authors.initials: H
authors.lastname: Nagata
authors.forename: M
authors.initials: M
authors.lastname: Tatemichi
authors.forename: S
authors.initials: S
authors.lastname: Kaneda
authors.forename: N
authors.initials: N
authors.lastname: Tsukada
authors.forename: H
authors.initials: H
authors.lastname: Ishii
authors.forename: T
authors.initials: T
authors.lastname: Hibi
mesh_terms: 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