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2022, Number 09

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Revista Médica Sinergia 2022; 7 (09)

Update on acute diverticulitis: physiopathology and initial management

Cascante GA, Arriola GJ, Castillo AR
Full text How to cite this article

Language: Spanish
References: 16
Page:
PDF size: 141.21 Kb.


Key words:

Diverticulitis, peritonitis, colorectal surgery, COVID-19.

ABSTRACT

Acute diverticulitis is a gastrointestinal disease that contributes significantly to national morbidity rates and health care spending. Risk factors include central obesity, smoking, and diets low in fiber and high in red meat. The most common manifestation consists of lower left abdominal pain, with systemic symptoms including fever and malaise. However, it can progress to peritonitis with hemodynamic instability. Hinchey classification is the most used scale to guide treatment. Hinchey stages I and II can be managed conservatively, with clear liquid diet, antibiotics, and abscess drainage if necessary. Some special cases could receive outpatient treatment safely and effectively. In contrast, patients at Hinchey stages III and IV have already developed peritonitis, and need urgent surgical management; Hartmann procedure is preferred. During COVID-19 pandemics, there was an inclination towards conservative and ambulatory treatment, over surgical treatment and hospitalization.


REFERENCES

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Revista Médica Sinergia. 2022;7