title: Management of Colonic Diverticulitis Tailored to Location and Severity: Comparison of the Right and the Left Colon.
abstract: OBJECTIVE
  This study assessed optimal management of colonic diverticulitis as functions of disease location and severity and factors associated with complicated diverticulitis.
  
  
  METHODS
  This retrospective review analyzed 202 patients diagnosed between 2007 and 2014 at Chonbuk National University Hospital, South Korea, with colonic diverticulitis by using abdominopelvic computed tomography. Diverticulitis location was determined, and disease severity was categorized using the modified Hinchey classification.
  
  
  RESULTS
  Patients included 108 males (53.5%) and 94 females (46.5%); of these, 167 patients (82.7%) were diagnosed with right-sided and 35 (17.3%) with left-sided colonic diverticulitis. Of the 167 patients with right-sided colonic diverticulitis, 12 (7.2%) had complicated and 155 (92.8%) had uncomplicated diverticulitis; of these, 157 patients (94.0%) were successfully managed conservatively. Of the 35 patients with left-sided colonic diverticulitis, 23 (65.7%) had complicated and 12 (34.3%) had uncomplicated diverticulitis; of these, 23 patients (65.7%) were managed surgically. Among patients with right-sided diverticulitis, those with complicated disease were significantly older (54.3 ± 12.7 years vs. 42.5 ± 13.4 years, P = 0.004) and more likely to be smokers (66.7% vs. 32.9%, P = 0.027) than those with uncomplicated disease. However, among patients with left-sided diverticulitis, those with complicated disease had significantly lower body mass index (BMI; 21.9 ± 4.7 kg/m2vs. 25.8 ± 4.3 kg/m2, P = 0.021) than those with uncomplicated disease.
  
  
  CONCLUSIONS
  Conservative management may be effective in patients with right-sided diverticulitis and patients with uncomplicated left-sided colonic diverticulitis. Surgical management may be required for patients with complicated left-sided diverticulitis. Factors associated with complicated diverticulitis include older age, smoking and lower BMI.
authors.affiliation: Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Byeoung Hoon
authors.initials: BH
authors.lastname: Chung
authors.affiliation: Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Gi Won
authors.initials: GW
authors.lastname: Ha
authors.affiliation: Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Min Ro
authors.initials: MR
authors.lastname: Lee
authors.affiliation: Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Jong Hun
authors.initials: JH
authors.lastname: Kim
keywords: Anti-bacterial agents/therapeutic use; Colonic diverticulitis; Computed tomography; Risk factors; Treatment outcome