title: Sigmoid diverticulitis in 2011: many questions; few answers.
abstract: OBJECTIVE
  Patients were studied after a first episode of acute left-colonic diverticulitis for the initial and later evolution of the disease with the aim of defining evidence-based indications for elective surgery.
  
  
  METHODS
  Relevant data from prospective studies were retrieved from a MEDLINE search of English language articles.
  
  
  RESULTS
  Young male patients (≤ 50 years of age) had a higher risk of CT-graded severe diverticulitis. After medical treatment of the first episode, the incidence of complications was highest for young patients with CT-graded severe diverticulitis and lowest for older patients with CT-graded moderate diverticulitis. Recurrence in the form of diffuse peritonitis was rare. CT grading of initial diverticulitis seemed to be a predictor of recurrence, whereas the role of age was less clear. A family history of diverticulitis might be predictive of recurrence.
  
  
  CONCLUSIONS
  CT grading of acute diverticulitis helps to predict poor outcome after medical treatment of a first episode. Elective surgical resection should be proposed to patients with residual symptoms who do not respond to conservative treatment. Additional research is needed to clarify the role of a genetic predisposition in the development of diverticulitis in young adults.
authors.affiliation: Clinique Générale Beaulieu, Geneva, Switzerland. p_ambrosetti@bluewin.ch
authors.forename: P
authors.initials: P
authors.lastname: Ambrosetti
authors.forename: P
authors.initials: P
authors.lastname: Gervaz
authors.forename: A
authors.initials: A
authors.lastname: Fossung-Wiblishauser
mesh_terms: D000367:Age Factors; D004239:Diverticulitis, Colonic / Q000000981:diagnostic imaging* / Q000628:therapy; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010538:Peritonitis / Q000000981:diagnostic imaging / Q000628:therapy; D011237:Predictive Value of Tests; D012008:Recurrence; D012737:Sex Factors; D012810:Sigmoid Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D014057:Tomography, X-Ray Computed