Clinical outcomes of complicated diverticulitis managed nonoperatively

Background Surgical resection is typically recommended for patients with computed tomography (CT)-confirmed complicated diverticulitis. This study was designed to assess outcomes of patients with complicated diverticulitis managed nonoperatively. Methods A retrospective study covering 14 years evaluated patients with complicated diverticulitis diagnosed by CT scan. Patient outcomes, including recurrence and need for operations, were reviewed. Results Of 256 patients identified, 99 were managed nonoperatively. Forty-six of the 99 patients had a recurrent episode of diverticulitis. Of these 46 patients, 20 underwent a sigmoid colon resection, with only 1 patient requiring a colostomy for obstruction. None of these recurrences resulted in the need for emergency resection. Conclusions Surgical treatment should play an important role in the management of patients with complicated diverticulitis because of the high risk of recurrence. However, nonoperative management may be appropriate in a select population if age or medical comorbidities preclude a safe operation since the need for emergency operation is unlikely.