title: Efficacy of conservative management in patients with right colonic diverticulitis.
abstract: BACKGROUND
  Although right colonic diverticulitis is more common than sigmoid diverticulitis, and its incidence has been increasing in Asian countries, there is no definitive treatment strategy for right colonic diverticulitis. This retrospective clinical study assessed the effect of conservative management in patients with right colonic diverticulitis.
  
  
  METHODS
  Of the 169 patients who were diagnosed with right colonic diverticulitis at Chonbuk National University Hospital, South Korea, from 2005 to 2012, 152 patients evaluated by abdominopelvic computed tomography (CT) and managed conservatively were included. CT findings were categorized by modified Hinchey classification, with stages Ib, II, III and IV, as well as fistula and obstruction defined as complicated diverticulitis. Factors associated with recurrence of diverticulitis were determined.
  
  
  RESULTS
  The mean age of 152 patients (87 males, 65 females) was 42.9 ± 13.8 years, median follow-up interval was 61 months (range, 17-113 months). At diagnosis, five patients (3.3%) had complicated diverticulitis. After treatment of first attack, 15 patients (9.9%) experienced recurrence of right colonic diverticulitis, including 10 (6.6%) within 12 months. Fourteen of these patients were successfully treated conservatively, whereas one failed conservative management and required surgical resection. Statistical analysis found no variables related to recurrence of right colonic diverticulitis.
  
  
  CONCLUSIONS
  Right colonic diverticulitis has a low rate of complicated diverticulitis at first attack and a low recurrence rate, with most recurrences being uncomplicated. Therefore, conservative management is effective in patients with right colonic diverticulitis. Close follow-up of patients for 12 months is required because most recurrences may occur within 12 months.
authors: Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Jeonbuk, South Korea.
authors: Gi Won
authors: GW
authors: Ha
authors: Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Jeonbuk, South Korea.
authors: Min Ro
authors: MR
authors: Lee
authors: Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Jeonbuk, South Korea.
authors: Jong Hun
authors: JH
authors: Kim
mesh_terms: D000328:Adult; D003106:Colon / Q000473:pathology; D000072700:Conservative Treatment / Q000592:standards*; D004239:Diverticulitis, Colonic / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: X-ray computed; ascending; colon; combination; diverticulitis; drug therapy; recurrence; tomography