Acute Diverticulitis: From Basic Concepts to Current Treatment
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Abstract
Acute diverticulitis (AD) is a common gastrointestinal disease characterized by abdominal symptoms that can lead to complications such as perforation, peritonitis, and sepsis. Risk factors include a low-fiber diet, high intake of red meat, obesity, sedentarism, alcoholism, and smoking. Computed tomography (CT) imaging is considered key for diagnosis and staging. Different scoring systems help guide treatment decisions, The Hinchey Classification, has been adapted for imaging interpretation. This system categorizes the severity of the disease into stages and helps predict postoperative morbidity and mortality rates, as well as the likelihood of recurrence in patients who are not managed operatively, therefore it’s the most used classification worldwide. Management of acute diverticulitis depends on disease severity. Antibiotics are recommended for mild cases to reduce recovery time and complications, especially for patients with multiple risk factors and comorbidities. On the other hand, complicated cases require surgical treatment based on the presence of abscesses, perforation, obstruction, or fistulas.
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References
I. Boone D., Plumb A., and Taylor, S. (Ed.). (2021). The Large Bowel. In Grainger & Allison’s Diagnostic Radiology (pp. 568–597). Elsevier - Health Sciences Division.
II. Jawad, N. and Skinner, C. (2021). Gastroenterology. In Kumar and Clark’s Clinical Medicine (pp. 1147–1224). Elsevier.
III. Steele, S. R., Hull, T. L., Hyman, N., Maykel, J. A., Read, T. E., & Whitlow, C. B. (Eds.). (2022). The ASCRS textbook of colon and rectal surgery. Springer International Publishing.
IV. Galandiuk, S., Netz, U., Morpurgo, E., Tosato S.M., Abu-Freha, N. and Ellis, C.T. (2022). Colon and Rectum. In Sabiston Textbook of Surgery (pp. 1320–1400). Elsevier.
V. Elsevier-Health Sciences Division. (2021). Clinical Overview: Diverticulitis. ClinicalKey. https://www.clinicalkey.es/#!/content/clinical_overview/67-s2.0-3d31d58f-e815-4526-9f26-2e76777823b3
VI. Cascante, Arriola, Castillo. Actualización sobre fisiopatología y manejo inicial de diverticulitis aguda. Revista Médica Sinergia. 2022;7(9):2215-5279. https://revistamedicasinergia.com/index.php/rms/article/download/894/1985/6128.
VII. Sánchez, J. E., Jaramillo, P. F., Calderon, S. E., Ortiz, P. M., Álvarez, R. P., & Guarnizo, J. N. (2023). Epidemiología, patogenia, diagnóstico y tratamiento de enfermedad diverticular, 2023. Ocronos, 6(5), 265.4. https://doi.org/10.58842/XBVM8097
VIII. Violi, A., Cambiè, G., Miraglia, C., Barchi, A., Nouvenne, A., Capasso, M., Leandro, G., Meschi, T., De' Angelis, G. L., & Di Mario, F. (2018). Epidemiology and risk factors for diverticular disease. Acta bio-medica : Atenei Parmensis, 89(9-S), 107–112. https://doi.org/10.23750/abm.v89i9-S.7924
IX. Marchante, I. S., & Mohedas, R. C. (2020). Enfermedad diverticular del intestino grueso. Medicine, 13(8), 434–440.
https://doi.org/10.1016/j.med.2020.05.012
X. Raña-Garibay, R., Salgado-Nesme, N., Carmona-Sánchez, R., Remes-Troche, J. M., Aguilera-Carrera, J., Alonso-Sánchez, L., Arnaud-Carreño, C., Charúa-Guindic, L., Coss-Adame, E., de la Torre-Bravo, A., Espinosa-Medina, D., Esquivel-Ayanegui, F., Roesch-Dietlen, F., López-Colombo, A., Muñoz-Torres, J. I., Noble-Lugo, A., Rojas-Mendoza, F., Suazo-Barahona, J., Stoopen-Rometti, M., Vergara-Fernández, O. (2019). Consenso mexicano sobre el diagnóstico y tratamiento de la enfermedad diverticular del colon. Revista de gastroenterologia de Mexico, 84(2), 220–240.
https://doi.org/10.1016/j.rgmx.2019.01.002
XI. Szuster Benavides, M., Muñoz Vargas, B., & Ulloa Velásquez, L. F. (2022). Generalidades de la diverticulitis aguda. Revista Medica Sinergia, 7(8), e842. https://doi.org/10.31434/rms.v7i8.842
XII. Hawkins, A. T., Wise, P. E., Chan, T., Lee, J. T., Glyn, T., Wood, V., Eglinton, T., Frizelle, F., Khan, A., Hall, J., Ilyas, M. I. M., Michailidou, M., Nfonsam, V. N., Cowan, M. L., Williams, J., Steele, S. R., Alavi, K., Ellis, C. T., Collins, D., … Lightner, A. L. (2020). Diverticulitis: An update from the age-old Paradigm. Current Problems in Surgery, 57(10), 100863. https://doi.org/10.1016/j.cpsurg.2020.100863
XIII. García Rossi, C., & Rodríguez Bolaños, D. (2019). Diverticulitis: revisión de la literatura en cuanto al manejo actual. Revista Clínica Escuela de Medicina UCR-HSJD, 9(2). https://doi.org/10.15517/rc_ucr-hsjd.v9i2.37357
XIV. Kim, N. E., & Hall, J. F. (2021). Acute diverticulitis: Surgical management. Seminars in Colon & Rectal Surgery, 32(1), 100799.
https://doi.org/10.1016/j.scrs.2020.100799
XV. Raña-Garibay RH, Salgado‐Nesme N, Carmona-Sánchez R, et al. Consenso mexicano sobre el diagnóstico y tratamiento de la enfermedad diverticular del colon. Revista de Gastroenterología de México. 2019;84(2):220-240.
doi:10.1016/j.rgmx.2019.01.002
XVI. ArchundiaGarcíaA.(2013).Cirugía2.McGraw Hill. https://accessmedicina.mhmedical.com/content.aspx?bookid=1434§ionid=94944541
XVII. Cascante, Arriola, Castillo. Actualización sobre fisiopatología y manejo inicial de diverticulitis aguda. Revista Médica Sinergia. 2022;7(9):2215-5279. https://revistamedicasinergia.com/index.php/rms/article/download/894/1985/6128.
XVIII. Azhar, N., Lambrichts, D., Lange, J., Yaqub, S., Oresland, T., Schultz, J., Bemelman, W., & Buchwald, P. (2023). Laparoscopic lavage for Hinchey III perforated diverticulitis: factors for treatment failure in two randomized clinical trials. The British Journal of Surgery, 110(7), 846–851. https://doi.org/10.1093/bjs/znad114
XIX. Mitreski, G., McGill, J., Nikolovski, Z., Jamel, W., Al-Kaisey, Y., Kam, N. M., Con, D., Ardalan, Z., & Kutaiba, N. (2022). Value of computed tomography scores in complicated acute diverticulitis. ANZ Journal of Surgery, 92(11), 2935–2941. https://doi.org/10.1111/ans.17913
XX. Steele, S. R., Hull, T. L., Hyman, N., Maykel, J. A., Read, T. E., & Whitlow, C. B. (Eds.). (2022). The ASCRS textbook of colon and rectal surgery. Springer International Publishing.
XXI. Hall, Hardiman, Lee, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Treatment of Left-Sided Colonic Diverticulitis. CLINICAL PRACTICE GUIDELINES. (2020);63(6):728-747.
https://fascrs.org/ascrs/media/files/DCR-tics-CPG-2020.pdf.
XXII. Szuster Benavides, Muñoz Vargas, Ulloa Velásquez. Vista de generalidades de la diverticulitis aguda. Revista Medica Sinergia. (2022);7(8): 2215-5279. https://revistamedicasinergia.com/index.php/rms/article/view/842/1951
XXIII. Definición y hechos sobre la enfermedad diverticular. (2021). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/informacion-de-la-salud/enfermedades-digestivas/diverticulosis-diverticulitis/definicion-informacio
XXIV. Enfermedad diverticular del colon y sus complicaciones. (2019, junio 22). HPC; HPC Hospital Privado de Comunidad.