title: Management of diverticulitis: results of a survey among gastroenterologists and surgeons.
abstract: OBJECTIVE
  The study aimed to investigate current management strategies for left-sided diverticulitis and compare them with current international guidelines. Differences between surgeons and gastroenterologists and between gastrointestinal and nongastrointestinal surgeons were assessed.
  
  
  METHODS
  A web-based survey of treatment options for uncomplicated and complicated diverticulitis was carried out among surgeons and gastroenterologists in the Netherlands. Only surgeons were asked about surgical strategy.
  
  
  RESULTS
  A total of 292 surgeons and 87 gastroenterologists responded, representing 92% of all surgical and 46% of all gastroenterology departments. Ninety per cent of respondents treated mild diverticulitis without antibiotics. About one-fifth (18% gastroenterologists; 19% surgeons) regarded a CT scan as mandatory in the initial assessment. Most surgeons and gastroenterologists used some form of bowel rest, would consider outpatient treatment and would perform a colonoscopy on follow up. For Hinchey Stage 3, 78% of surgeons would consider resection and primary anastomosis and laparoscopic lavage was viewed as a valid alternative by 30% of gastrointestinal and 2% of nongastrointestinal surgeons. For Hinchey stage 4, 46% of gastrointestinal and 72% of nongastrointestinal surgeons would always perform Hartmann's procedure.
  
  
  CONCLUSIONS
  The treatment of diverticulitis in the Netherlands shows major differences when compared with guidelines for all stages of disease.
authors.affiliation: Department of Surgery, Kennemer Gasthuis, Haarlem, The Netherlands. ndekorte@yahoo.com
authors.forename: N
authors.initials: N
authors.lastname: de Korte
authors.forename: B R
authors.initials: BR
authors.lastname: Klarenbeek
authors.forename: J Ph
authors.initials: JP
authors.lastname: Kuyvenhoven
authors.forename: R M H
authors.initials: RM
authors.lastname: Roumen
authors.forename: M A
authors.initials: MA
authors.lastname: Cuesta
authors.forename: H B A C
authors.initials: HB
authors.lastname: Stockmann
mesh_terms: D000553:Ambulatory Care; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003082:Colectomy; D003113:Colonoscopy; D004032:Diet; D004239:Diverticulitis, Colonic / Q000000981:diagnostic imaging / Q000628:therapy*; D005762:Gastroenterology / Q000706:statistics & numerical data*; D013502:General Surgery / Q000706:statistics & numerical data*; D019983:Guideline Adherence; D006801:Humans; D009426:Netherlands; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D018712:Analgesics, Non-Narcotic; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal