Diverticulitis

Clinical Manifestations

• Complicated diverticulitis includes diverticulitis associated with uncontained, free perforation with systemic inflammatory response, fistula, abscess, stricture, or obstruction
• Uncomplicated diverticulitis is diverticulitis not meeting the above definition, and includes microperforation with small amounts of contained, extraluminal gas without systemic inflammatory response

Management

• For uncomplicated diverticulitis:
  • Observation alone, or
  • Ten days of amoxicillin-clavulanic acid (preferred), or a combination of fluoroquinolone and metronidazole

Further Reading

• AGA Clinical Practice Update on Medical Management of Colonic Diverticulitis: Expert Review. Gastroenterol. 2021:160(3)906-911.E1. doi: 10.1053/j.gastro.2020.09.059
• The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Treatment of Left-Sided Colonic Diverticulitis. Dis Colon Rectum. 2020;63:728–747. doi: 10.1097/DCR.0000000000001679