Samenvatting richtlijn diverticulitis van het colon

Conflict of interest and financial support: disclosure forms provided by the authors are available along with the full text of this article at www.ntvg.nl; search for A6124, click on ‘Belangenverstrengeling’ (‘Conflict of interest’).

• The natural course of diverticulitis is usually mild and often requires only conservative treatment.

• The combination of pain in the lower left abdomen on physical examination, the absence of vomiting and a CRP > 50 mg/l is highly predictive of diverticulitis; further investigation by means of imaging may then be omitted.

• An initial ultrasound – and CT scanning only if this investigation proves negative or inconclusive – provides the best results in terms of imaging.

• There is no evidence substantiating the efficacy of routine antibiotic administration to patients with clinically mild and uncomplicated diverticulitis.

• Pericolic or pelvic abscesses can initially be treated with antibiotics, possibly in combination with percutaneous drainage; surgical intervention is only necessary if this treatment regimen fails.

• A patient with perforated diverticulitis resulting in peritonitis should undergo an operation; the optimal surgical strategy is currently under debate.