Current treatment for diverticulitis: state of affairs in 2016
van Dijk, S.; Boermeester, M.A.
Nederlands Tijdschrift Voor Geneeskunde 160: D69
2016
ISSN/ISBN: 0028-2162 PMID: 27334091 Document Number: 689188
- Uncomplicated diverticulitis does not routinely require antibiotic treatment and can even be managed in the outpatient setting.- As yet no medical therapies have proven themselves useful in the prevention of recurrence.- Complicated diverticulitis with an abscess smaller than 4 cm is treated with antibiotics, larger abscesses are treated by percutaneous drainage, and only if treatment fails surgery is required.- Laparoscopic lavage is no better than partial resection in purulent peritonitis.- Perforated diverticulitis with faecal peritonitis is treated by a Hartmann's procedure; in selected cases resection and primary anastomosis may be considered.- The decision whether a resection should be laparoscopic or open is based on the surgeon's experience.- The choice for elective resection for recurrent diverticulitis is still made on a patient-by-patient basis.- Only high-risk patients should have a follow-up colonoscopy to exclude malignancy. The remaining patients are referred back to the Dutch national colorectal cancer screening programme.