Management of diverticulitis: results of a survey among gastroenterologists and surgeons

• Published in: Colorectal disease Vol. 13; no. 12; pp. e411 - e417
• Main Authors: de Korte, N., Klarenbeek, B. R., Kuyvenhoven, J. Ph, Roumen, R. M. H., Cuesta, M. A., Stockmann, H. B. A. C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.12.2011
• Subjects: Ambulatory Care; Analgesics, Non-Narcotic - therapeutic use; Anti-Bacterial Agents - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; antibiotics; Chi-Square Distribution; Colectomy; Colonoscopy; Diet; Diverticulitis; Diverticulitis, Colonic - diagnostic imaging; Diverticulitis, Colonic - therapy; Gastroenterology - statistics & numerical data; General Surgery - statistics & numerical data; Guideline Adherence; Humans; imaging; Netherlands; Practice Guidelines as Topic; Practice Patterns, Physicians' - statistics & numerical data; Severity of Illness Index; surgery; survey; Tomography, X-Ray Computed; treatment; Ultrasonography
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/j.1463-1318.2011.02744.x

Aim  The study aimed to investigate current management strategies for left‐sided diverticulitis and compare them with current international guidelines. Differences between surgeons and gastroenterologists and between gastrointestinal and nongastrointestinal surgeons were assessed. Method  A web‐based survey of treatment options for uncomplicated and complicated diverticulitis was carried out among surgeons and gastroenterologists in the Netherlands. Only surgeons were asked about surgical strategy. Results  A total of 292 surgeons and 87 gastroenterologists responded, representing 92% of all surgical and 46% of all gastroenterology departments. Ninety per cent of respondents treated mild diverticulitis without antibiotics. About one‐fifth (18% gastroenterologists; 19% surgeons) regarded a CT scan as mandatory in the initial assessment. Most surgeons and gastroenterologists used some form of bowel rest, would consider outpatient treatment and would perform a colonoscopy on follow up. For Hinchey Stage 3, 78% of surgeons would consider resection and primary anastomosis and laparoscopic lavage was viewed as a valid alternative by 30% of gastrointestinal and 2% of nongastrointestinal surgeons. For Hinchey stage 4, 46% of gastrointestinal and 72% of nongastrointestinal surgeons would always perform Hartmann’s procedure. Conclusion  The treatment of diverticulitis in the Netherlands shows major differences when compared with guidelines for all stages of disease.