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KMID : 0356720100260010022
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Journal of the Korean Society of Coloproctology
2010 Volume.26 No. 1 p.22 ~ p.28
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Management of Right Colon Diverticulitis
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Jang Jong-Ik
Lee Yun-Sik
Lim Yang-Soo
Choi Jong-Woo
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Abstract
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Purpose: There are still many controversial aspects in the management of right colon diverticulitis. The aim of this study is to find an appropriate treatment for right colon diverticulitis.
Methods: We retrospectively reviewed the medical records of 88 patients who were admitted with right colon diverticulitis to Wallace Memorial Baptist Hospital from January 2001 to December 2007.
Results: The patients enrolled in this study included 52 men and 36 women. The mean age was 39.6 yr, ranging from 13 to 84 yr. Fifty-four of 88 patients underwent conservative treatment for right colon diverticulitis, and 34 of 88 patients underwent operative treatment. There were 5 cases of recurrence in the conservative treatment group, but there were no cases of recurrence in the operative treatment group. We experienced 43 cases with right colon diverticulitis at the operational fields, including 9 cases that underwent conservative treatment after an appendectomy: eleven cases that underwent conservative treatment after an appendectomy or an appendectomy with diverticulectomy, 19 cases that underwent an ileocecectomy, and 13 cases that underwent a right hemicolectomy. There were no statistically significant difference in complications among 3 groups (P=0.148). However, there were statistical differences among the 3 groups in the length of hospital stay (P=0.016), and the use of intravenous antibiotics (P<0.001), and the use of oral antibiotics (P=0.019).
Conclusions: When the preoperative diagnosis is exact, uncomplicated right colon diverticulitis can be managed by conservative treatment. On the other hand, an ileocecectomy or a right hemicolectomy is the proper treatment for complicated right colon diverticulitis. However, if uncomplicated right colon diverticulitis is diagnosed intraoperatively, conservative treatment or a diverticulectomy should be considered.
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KEYWORD
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Right colon, Diverticulitis, Conservative treatment, Operative treatment
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