The surgeon's view

Digestive Diseases
Asha Senapati

Abstract

Diverticular disease affects up to 50% of people by the time they reach the age of 80. The major complications of diverticular disease (abscess, perforation, fistula, obstruction and bleeding) have their own management pathways, but the treatment of uncomplicated diverticulitis is controversial. On initial presentation, diverticulitis is always treated conservatively. Whether this should be followed by resectional surgery has been the subject of speculation for many decades. The American Society of Colon and Rectal Surgeons recommended in 2000 that an elective resection should follow two attacks of acute diverticulitis. Much of the work underpinning their policy was based on seminal studies by Parks in the 1960s and 1970s who followed cohorts of patients with diverticular disease and examined their outcomes. However, many of these studies were based on inaccurate diagnostic data where the diagnosis was made primarily on clinical grounds. Investigations such as barium enema or colonoscopy are not reliable in confirming the presence of inflammation. Since CT scanning has become routine, the diagnosis of acute diverticulitis can now be made accurately. In recent years much work has been done, such as by Ambrosetti, who has produce...Continue Reading

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Citations

Dec 29, 2012·Updates in Surgery·Tatiana BargelliniAndrea Valeri
Sep 3, 2013·Annals of Emergency Medicine·Casey M SmolarzRawle A Seupaul
Mar 6, 2015·International Journal of Colorectal Disease·M A W StamW A Draaisma
Mar 12, 2018·International Journal of Colorectal Disease·Lino PoleseStefano Merigliano

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