Department of digestive surgery, centre hospitalier départemental de Vendée, 85000 La-Roche-sur-Yon, France.
Emergency department, centre hospitalier départemental de Vendée, 85000 La-Roche-sur-Yon, France.
J Visc Surg. 2023 Feb;160(1):27-32. doi: 10.1016/j.jviscsurg.2021.10.005. Epub 2022 Apr 19.
Recent clinical practice recommendations have radically modified the management of colonic diverticulitis. The goal of our study was to evaluate a treatment pathway for uncomplicated diverticulitis and to analyze the outcome (patient compliance, treatment failure and complications).
All patients who presented to the emergency department with the diagnosis of uncomplicated diverticulitis were prospectively included in this study. The treatment pathway included an outpatient clinical re-assessment by a gastrointestinal surgeon. In case of symptomatic treatment failure, oral antibiotics were prescribed. If developed clinical signs of severity developed, the patient was referred to the emergency department for new laboratory and imaging workup.
Eighty-seven patients were included. The mean interval before re-assessment was 2.8 days. Fifty-nine patients (67.8%) had symptomatic treatment upon discharge from the emergency department and were reassessed as outpatients by the surgical team. Patient evolution was satisfactory for 45 (76.3%); 10 (16.9%) required oral antibiotics. One (1.7%) patient developed complicated diverticulitis. Thirty-four (39.1%) patients did not comply with the current recommendations.
In our experience, uncomplicated diverticulitis can be treated effectively in an ambulatory setting followed by early re-assessment by a surgeon.
最近的临床实践建议彻底改变了结肠憩室炎的治疗方法。我们的研究目的是评估一种治疗单纯性憩室炎的方法，并分析其结果（患者依从性、治疗失败和并发症）。
所有因单纯性憩室炎就诊于急诊科的患者均前瞻性纳入本研究。治疗途径包括胃肠外科医生的门诊临床再评估。如果症状性治疗失败，给予口服抗生素。如果出现严重的临床症状，患者将被转至急诊科进行新的实验室和影像学检查。
共纳入 87 例患者。重新评估前的平均间隔时间为 2.8 天。59 例（67.8%）患者在急诊科出院时接受了症状性治疗，并由外科团队进行门诊再评估。45 例（76.3%）患者病情缓解良好；10 例（16.9%）需要口服抗生素。1 例（1.7%）患者发生复杂性憩室炎。34 例（39.1%）患者不遵守当前建议。
根据我们的经验，单纯性憩室炎可在门诊环境中进行有效治疗，随后由外科医生进行早期再评估。
