Department of Surgical Affairs, RCSI Dublin, Dublin, Ireland,
Department of Surgical Affairs, RCSI Dublin, Dublin, Ireland.
Dig Surg. 2019;36(3):195-205. doi: 10.1159/000488216. Epub 2018 Apr 19.
Symptomatic diverticular disease is challenging for patients, clinicians and health services. The prevalence increases with age and BMI and as such, the burden of this disease is set to increase with higher rates of acute presentations already documented. The natural history of recurrent episodes, complications and symptom progression is not fully understood. Furthermore, medical and surgical management strategies are under constant appraisal, debate and evolution.
A review of the contemporary literature was performed to examine the emerging trend towards conservative treatment.
Routine use of in-patient, intravenous antibiotics may not be required and outpatient management is possible for certain patients. Universal colonoscopy examination after uncomplicated acute diverticulitis is controversial but is mandatory after complicated episodes. Recent, high-profile, clinical trials suggest that less aggressive surgical management of both acute and chronic presentations may be feasible in some cases.
Diverticulitis is a common yet challenging topic that demands clinicians to provide an individualised yet evidence-based approach.
有症状的憩室疾病给患者、临床医生和医疗服务带来了挑战。患病率随年龄和 BMI 的增加而增加，因此，随着已记录到更高的急性发作率，这种疾病的负担预计将会增加。反复发作、并发症和症状进展的自然病史尚不完全清楚。此外，医疗和手术管理策略不断受到评估、辩论和发展。
对当代文献进行了回顾，以研究保守治疗的新趋势。
常规使用住院静脉内抗生素可能不是必需的，某些患者可以进行门诊治疗。在没有并发症的急性憩室炎后进行常规结肠镜检查存在争议，但在复杂病例后则是强制性的。最近的备受瞩目的临床试验表明，在某些情况下，对急性和慢性表现进行不那么激进的手术治疗可能是可行的。
憩室炎是一个常见但具有挑战性的话题，要求临床医生提供个体化但基于证据的方法。
