Management of Diverticulitis

In patients presenting with acute diverticulitis, initial evaluation uses CT scan to assess disease severity. In uncomplicated cases, antibiotic therapy with or without hospital admission is appropriate. For patients presenting with peritonitis due to free perforation, surgical intervention with either a Hartmann’s procedure or a sigmoid resection with a colorectal anastomosis and a diverting loop ileostomy are options, depending upon the patient’s physiologic status. For patients with disease complicated by an abscess, percutaneous drainage with antibiotic therapy is appropriate. Elective resection for repeated episodes should be considered and should include removal of the entire sigmoid and rectosigmoid colon.