title: Elective operation after acute complicated diverticulitis: is it still mandatory?
abstract: OBJECTIVE
  To investigate recurrence rates, patterns and complications after nonoperatively managed complicated diverticulitis (CD).
  
  
  METHODS
  A retrospective study of patients treated for CD was performed. CD was defined on computed tomography by the presence of a localized abscess, pelvic abscess or extraluminal air. For follow-up, patients were contacted by telephone. Numbers of elective surgeries, recurrences and abdominal pain were analyzed.
  
  
  RESULTS
  A total of 114 patients (median age 57 years (range 29-97)), were admitted for CD. Nine patients required surgical intervention for failure of conservative therapy (Hartmann's procedure: n = 6; resection and colorectal anastomosis: n = 3). Of the 105 remaining patients, 24 (22.9%) underwent elective sigmoid resection. The 81 (71%) non-operated patients were all contacted after a median follow-up of 32 mo (4-63). Among them, six had developed a recurrent episode of diverticulitis at a median follow-up of 12 mo (6-36); however, no patient required hospitalization. Sixty-eight patients (84%) were asymptomatic and 13 (16%) had recurrent abdominal pain.
  
  
  CONCLUSIONS
  Conservative policy is feasible and safe in 71% of cases, with a low medium-term recurrence risk.
authors.affiliation: Valérie Bridoux, Marlène Antor, Lilian Schwarz, Julien Cahais, Haitham Khalil, Francis Michot, Jean-Jacques Tuech, Department of Digestive Surgery, Rouen University Hospital, 76031 Rouen Cedex, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Bridoux
authors.affiliation: Valérie Bridoux, Marlène Antor, Lilian Schwarz, Julien Cahais, Haitham Khalil, Francis Michot, Jean-Jacques Tuech, Department of Digestive Surgery, Rouen University Hospital, 76031 Rouen Cedex, France.
authors.forename: Marlène
authors.initials: M
authors.lastname: Antor
authors.affiliation: Valérie Bridoux, Marlène Antor, Lilian Schwarz, Julien Cahais, Haitham Khalil, Francis Michot, Jean-Jacques Tuech, Department of Digestive Surgery, Rouen University Hospital, 76031 Rouen Cedex, France.
authors.forename: Lilian
authors.initials: L
authors.lastname: Schwarz
authors.affiliation: Valérie Bridoux, Marlène Antor, Lilian Schwarz, Julien Cahais, Haitham Khalil, Francis Michot, Jean-Jacques Tuech, Department of Digestive Surgery, Rouen University Hospital, 76031 Rouen Cedex, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Cahais
authors.affiliation: Valérie Bridoux, Marlène Antor, Lilian Schwarz, Julien Cahais, Haitham Khalil, Francis Michot, Jean-Jacques Tuech, Department of Digestive Surgery, Rouen University Hospital, 76031 Rouen Cedex, France.
authors.forename: Haitham
authors.initials: H
authors.lastname: Khalil
authors.affiliation: Valérie Bridoux, Marlène Antor, Lilian Schwarz, Julien Cahais, Haitham Khalil, Francis Michot, Jean-Jacques Tuech, Department of Digestive Surgery, Rouen University Hospital, 76031 Rouen Cedex, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Michot
authors.affiliation: Valérie Bridoux, Marlène Antor, Lilian Schwarz, Julien Cahais, Haitham Khalil, Francis Michot, Jean-Jacques Tuech, Department of Digestive Surgery, Rouen University Hospital, 76031 Rouen Cedex, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Tuech
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology / Q000628:therapy; D015746:Abdominal Pain / Q000209:etiology / Q000628:therapy; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003082:Colectomy / Q000009:adverse effects; D003131:Combined Modality Therapy; D004239:Diverticulitis, Colonic / Q000150:complications / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D017558:Elective Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects; D005602:France; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Diverticular abscess; Diverticulosis; Hinchey classification; Percutaneous drainage; Recurrent diverticulitis