Weizman AV, Nguyen GC. Diverticular disease: epidemiology and management

University of Toronto, Toronto, Canada.
Canadian journal of gastroenterology = Journal canadien de gastroenterologie (Impact Factor: 1.98). 07/2011; 25(7):385-9.
Source: PubMed


Diverticular disease of the colon is among the most prevalent conditions in western society and is among the leading reasons for outpatient visits and causes of hospitalization. While previously considered to be a disease primarily affecting the elderly, there is increasing incidence among individuals younger than 40 years of age. Diverticular disease most frequently presents as uncomplicated diverticulitis, and the cornerstone of management is antibiotic therapy and bowel rest. Segmental colitis associated with diverticula shares common histopathological features with inflammatory bowel disease and may benefit from treatment with 5-aminosalicylates. Surgical management may be required for patients with recurrent diverticulitis or one of its complications including peridiverticular abscess, perforation, fistulizing disease, and strictures and ⁄ or obstruction.

Full-text preview

Available from:
  • Source
    • "It is believed that recurrent attacks of diverticulitis provoke scarring and adhesion formation, so localized perforations and abscesses may appear instead of generalized peritonitis [4]. The management of acute diverticulitis includes fluid and antibiotic support, percutaneous drain abscess drainage or resection, and 1-or 2-stage anastomosis, depending on each individual case [13]. The first colon resection for the treatment of a diverticular perforation was reported by Mayo in 1907. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Diverticular perforation is a common complication of diverticulitis and can lead to the creation of abscesses. The presence of such abscesses on the abdominal wall is rare and can lead to misdiagnosis. We present the case of a patient with abdominal pain and the formation of a large left lumbar abscess due to perforation of a diverticulum of the left colon and our surgical treatment of choice with favorable results.
    Full-text · Article · Dec 2015
  • Source
    • "Complicated diverticulitis may be classified according to Hinchey into four stages [1] (Table 1). Treatment of perforated diverticulitis with peritonitis is a source of controversy [2]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background The combination of perforated diverticulitis in a lumbar hernia constitutes an extremely rare condition. Case presentation We report a case of a 66 year old Caucasian woman presenting with perforated sigmoid diverticulitis localized in a lumbar hernia following iliac crest bone graft performed 18 years ago. Emergency treatment consisted of laparoscopic peritoneal lavage. Elective sigmoid resection was scheduled four months later. At the same time a laparoscopic hernia repair with a biologic mesh graft was performed. Conclusion This case shows a very seldom clinical presentation of lumbar hernia. Secondary colonic resection and concurrent hernia repair with a biologic implant have proven useful in treating this rare condition.
    Full-text · Article · Jul 2014 · BMC Surgery
  • Source
    • "Colonic diverticulosis is characterized by the presence of pockets that occur when colonic mucosa and submucosa herniate through defects in the muscle layer of the colon wall.1 Diverticulosis is commonly found in the western world. Although it has been thought that diverticulosis is a rare condition in developing nations, there is some indication that the prevalence of colonic diverticulosis is increasing throughout the world, probably because of changes in lifestyle.2 Although most people with diverticulosis remain asymptomatic, about one quarter of them will develop an episode of symptomatic diverticular disease and up to 5% an episode of acute diverticulitis.3 "
    [Show abstract] [Hide abstract]
    ABSTRACT: Acute diverticulitis of the colon represents a significant burden for national health systems, in terms of direct and indirect costs. Although current guidelines recommend use of antibiotics for the outpatient treatment of acute uncomplicated diverticulitis, evidence for this is still lacking. Hence, significant effort is now being made to identify the appropriate therapeutic approach to treat and prevent relapses of diverticulitis. Outpatient treatment has been identified as a safe and effective therapeutic approach in up to 90% of patients with uncomplicated diverticulitis. It allows important costs saving to health systems without a negative influence on quality of life for patients with uncomplicated diverticulitis, and reduces health care costs by more than 60%.
    Full-text · Article · Mar 2014 · Drug, Healthcare and Patient Safety
Show more