right-sided colonic diverticulitis

Q: Right-sided (cecal) diverticulitis is more common in younger patients?

A) True

B) False

Answer: A

Right-sided diverticulitis is relatively unknown in the Western world but is common in Asian countries. It tends to occur in younger patients and fortunately tends to have fewer complications as well as recurrences. Medical management is usually sufficient, and very rarely requires surgery. Many of these patients get misdiagnosed as having appendicitis

Treatment with antibiotic is usually sufficient. In a systematic review and meta-analysis of 11 studies, the pooled recurrence rate after nonoperative management was 12 percent (95% CI 10 to 15 percent) with a median follow-up of 34 months [113]. Only 10 percent of those who recurred required urgent surgery at the first recurrence, and there was no mortality. A right hemicolectomy may be required if there is a suspicion of underlying carcinoma.

#GI

#surgical-critical-care

References:

1. Oh HK, Han EC, Ha HK, et al. Surgical management of colonic diverticular disease: discrepancy between right- and left-sided diseases. World J Gastroenterol 2014; 20:10115.

2. Lee YF, Tang DD, Patel SH, et al. Recurrence of Acute Right Colon Diverticulitis Following Nonoperative Management: A Systematic Review and Meta-analysis. Dis Colon Rectum 2020; 63:1466.

3. Hildebrand P, Kropp M, Stellmacher F, et al. Surgery for right-sided colonic diverticulitis: results of a 10-year-observation period. Langenbecks Arch Surg 2007; 392:143.