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Clin Colon Rectal Surg 2024; 37(06): 359-367
DOI: 10.1055/s-0043-1777439
Review Article

Diverticulitis: A Review of Current and Emerging Practice-Changing Evidence

Sonia Wu
1   Department of Digestive Surgery, Centre Hospitalier Universitaire de Montréal, Montreal, QC, Canada
,
Maher Al Khaldi
1   Department of Digestive Surgery, Centre Hospitalier Universitaire de Montréal, Montreal, QC, Canada
,
Carole S. Richard
1   Department of Digestive Surgery, Centre Hospitalier Universitaire de Montréal, Montreal, QC, Canada
,
François Dagbert
1   Department of Digestive Surgery, Centre Hospitalier Universitaire de Montréal, Montreal, QC, Canada
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Abstract

Acute diverticulitis represents a common colorectal emergency seen in the Western world. Over time, management of this condition has evolved. This review aims to highlight recent evidence and update current recommendations. Notable evidence has emerged in certain aspects of diverticulitis. This includes disease pathogenesis, as emerging data suggest a potentially greater role for the microbiome and genetic predisposition than previously thought. Acute management has also seen major shifts, where traditional antibiotic treatment may no longer be necessary for acute uncomplicated diverticulitis. Following successful medical management of acute diverticulitis, indications for elective sigmoidectomy have decreased. The benefit of emergency surgery remains for peritonitis, sepsis, obstruction, and acute diverticulitis in certain immunocompromised patients. Routine colonoscopy, once recommended after all acute diverticulitis episodes, has been shown to be beneficial for cancer exclusion in a distinct patient population. Despite advances in research, certain entities remain poorly understood, such as smoldering diverticulitis and symptomatic uncomplicated diverticular disease. As research in the field expands, paradigm shifts will shape our understanding of diverticulitis, influencing how clinicians approach management and educate patients.

Keywords

diverticulitis - diverticular disease - acute care surgery - colorectal surgery


Publication History

Article published online:
13 December 2023

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