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diverticulitis
DIVERTICULITIS
Treatment Guideline Chart
Diverticulitis is the inflammation of the diverticulum which is a herniation of the mucosa and submucosa of the colonic wall that may fill with fecal material or undigested food particles. 
Abdominal pain is usually localized, abrupt, steady and may worsen over time.
Other signs and symptoms are fever, anorexia, nausea without vomiting, and altered bowel movements, commonly constipation but may also present with diarrhea or tenesmus.

Diverticulitis Treatment

Surgical Intervention

  • Surgical treatment is usually only needed in 20-30% of patients with acute diverticulitis
  • Patients with uncomplicated diverticulitis must be monitored for complications requiring surgery

Indications

  • Abdominal or pelvic abscesses (Hinchey stage I and II)
    • Diverticular abscesses that cannot be drained completely via CT-guided percutaneous procedure
    • Laparotomy may be needed if the abscess cannot be drained or no improvement in condition was noted following drainage
  • Suppurative/purulent peritonitis secondary to a ruptured abscess (Hinchey stage III)
    • May do laparoscopic lavage and drainage or colectomy
  • Intestinal perforation with fecal peritonitis (Hinchey stage IV)
    • Resection is recommended
  • Intestinal obstruction or stricture
  • Fistula formation
  • Failure of medical treatment
  • Inability to rule out cancer
  • Recurrent episodes of acute diverticulitis
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