Skip to main content

20.05.2016 | Scientific Review | Ausgabe 10/2016

World Journal of Surgery 10/2016

Contemporary Review of Risk-Stratified Management in Acute Uncomplicated and Complicated Diverticulitis

World Journal of Surgery > Ausgabe 10/2016
Marja A. Boermeester, David J. Humes, George C. Velmahos, Kjetil Søreide



Acute colonic diverticulitis is a common clinical condition. Severity of the disease is based on clinical, laboratory, and radiological investigations and dictates the need for medical or surgical intervention. Recent clinical trials have improved the understanding of the natural history of the disease resulting in new approaches to and better evidence for the management of acute diverticulitis.


We searched the Cochrane Library (years 2004–2015), MEDLINE (years 2004–2015), and EMBASE (years 2004–2015) databases. We used the search terms “diverticulitis, colonic” or “acute diverticulitis” or “divertic*” in combination with the terms “management,” “antibiotics,” “non-operative,” or “surgery.” Registers for clinical trials (such as the WHO registry and the https://​clinicaltrials.​gov/​) were searched for ongoing, recruiting, or closed trials not yet published.


Antibiotic treatment can be avoided in simple, non-complicated diverticulitis and outpatient management is safe. The management of complicated disease, ranging from a localized abscess to perforation with diffuse peritonitis, has changed towards either percutaneous or minimally invasive approaches in selected cases. The role of laparoscopic lavage without resection in perforated non-fecal diverticulitis is still debated; however, recent evidence from two randomised controlled trials has found a higher re-intervention in this group of patients.


A shift in management has occurred towards conservative management in acute uncomplicated disease. Those with uncomplicated acute diverticulitis may be treated without antibiotics. For complicated diverticulitis with purulent peritonitis, the use of peritoneal lavage appears to be non-superior to resection.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Weitere Produktempfehlungen anzeigen
Über diesen Artikel

Weitere Artikel der Ausgabe 10/2016

World Journal of Surgery 10/2016 Zur Ausgabe

Innovative Surgical Techniques Around the World

Intra-Operative Indocyanine Green Angiography of the Parathyroid Gland

  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Chirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.