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01-06-2020 | Computed Tomography | Original Scientific Report

Short- and Long-Term Outcomes of Right-Sided Diverticulitis: Over 15 Years of North American Experience

Authors: Jesse Zuckerman, Richard Garfinkle, Carol-Ann Vasilevksy, Gabriela Ghitulescu, Julio Faria, Nancy Morin, Marylise Boutros

Published in: World Journal of Surgery | Issue 6/2020

Abstract

Background

Right-sided colonic diverticulitis represents less than 5% of diverticulitis cases in North America. The purpose of this study was to describe the management and outcomes for patients with a first episode of right-sided diverticulitis in a North American center.

Methods

This was a retrospective cohort study, including all patients managed for right-sided diverticulitis at a single tertiary-care institution from 2000 to 2017. Patient demographics, disease characteristics, and treatment strategies were described. Short- (emergency surgery, operative morbidity, treatment failure) and long-term (recurrence, elective operation) outcomes were reported. Patients with right-sided diverticulitis were then compared to a cohort of patients with left-sided diverticulitis.

Results

Sixty-seven patients were managed for a first episode of right-sided diverticulitis, three (4.5%) of which were subsequently diagnosed with right-sided colon cancer; 64 patients therefore formed the population. Mean age was 51.2 ± 17.7 years. Eight patients (12.5%) self-identified as being Asian. The majority of patients had uncomplicated disease (90.6%); six (9.4%) presented with complicated diverticulitis. Most cases were diagnosed by computed tomography (78.1%), while 17.2% were diagnosed intra-operatively and 4.7% by pathology. Almost all patients diagnosed by computed tomography were managed nonoperatively. Fifteen patients (23.4%) were managed surgically: ten for suspected appendicitis, three for suspected colon mass, and two for diffuse peritonitis. After a median follow-up of 74.8 months (IQR 30.2–130.5), only two patients (3.1%) developed recurrent right-sided diverticulitis. Among patients managed nonoperatively, recurrence was significantly lower in patients with right-sided diverticulitis relative to left-sided diverticulitis (4.1% vs. 32.8%, p < 0.001).

Conclusions

Right-sided diverticulitis can be successfully managed nonoperatively with low rates of recurrence. In populations in which this condition is more seldom observed, underlying colon cancers should be considered.

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Title: Short- and Long-Term Outcomes of Right-Sided Diverticulitis: Over 15 Years of North American Experience
Authors: Jesse Zuckerman
Richard Garfinkle
Carol-Ann Vasilevksy
Gabriela Ghitulescu
Julio Faria
Nancy Morin
Marylise Boutros
Publication date: 01-06-2020
Publisher: Springer International Publishing
Keywords: Computed Tomography
Computed Tomography
Appendicitis
Appendicitis
Diverticulitis
Colon Cancer
Colon Cancer
Published in: World Journal of Surgery / Issue 6/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05431-3

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Short- and Long-Term Outcomes of Right-Sided Diverticulitis: Over 15 Years of North American Experience

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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