title: Conservative treatment of right-sided colonic diverticulitis.
abstract: BACKGROUND
  Diverticulosis of the right colon occurs in a small percentage of patients in Western countries. Clinical presentation of right-sided colon diverticulitis is indistinguishable from that of acute appendicitis, and the majority of patients undergo surgical intervention for presumed appendicitis. The liberal use of diagnostic radiological modalities whenever appendicitis was suspected led to correct diagnosis and also to more preoperative diagnosis of right-sided diverticulitis, which consented conservative medical therapy in cases of uncomplicated right-sided diverticulitis. The aim of the study was to report the outcome in patients with right-sided diverticulitis diagnosed nonoperatively using computed tomography scanning and treated conservatively.
  
  
  METHODS
  Patients with clinical and radiological diagnosis of cecal or right colon diverticulitis treated conservatively between January 2005 and December 2007 were included. The demographic and clinical data were retrospectively analyzed.
  
  
  RESULTS
  Fifteen patients were included in this study. The median age was 52 years (range, 34-72 years) and the duration of symptoms was 4 days (range, 1-9 days) before the diagnosis. The median hospital stay was 5 days (range, 1-9 days). All patients were successfully treated with medical therapy. During a median follow-up of 32 months (range, 24-52 months) only one patient (6.6%) had a recurrent attack, and he was successfully treated again with medical therapy.
  
  
  CONCLUSIONS
  The routine use of the computed tomography scan for abdominal pain in the right lower quadrant, and whenever right-sided diverticulitis is suspected, improves diagnosis and reduces surgical interventions. The current study provides additional data in support of conservative therapy as the initial treatment in acute right-sided diverticulitis, even in cases of recurrence.
authors.affiliation: Hasharon Hospital Rabin Medical Center, Sackler School of Medicine, Tel-Aviv University, Petah-Tikva, Israel. nidalissa@clalit.org.il
authors.forename: Nidal
authors.initials: N
authors.lastname: Issa
authors.forename: Haiem
authors.initials: H
authors.lastname: Paran
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yasin
authors.forename: David
authors.initials: D
authors.lastname: Neufeld
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001064:Appendicitis / Q000000981:diagnostic imaging; D003113:Colonoscopy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004239:Diverticulitis, Colonic / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D019564:Unnecessary Procedures
chemical_list: D000900:Anti-Bacterial Agents