The out-patient management of patients with acute mild-to-moderate colonic diverticulitis
Article first published online: 24 MAR 2005
Alimentary Pharmacology & Therapeutics
Volume 21, Issue 7, pages 889–897, April 2005
How to Cite
Mizuki, A., Nagata, H., Tatemichi, M., Kaneda, S., Tsukada, N., Ishii, H. and Hibi, T. (2005), The out-patient management of patients with acute mild-to-moderate colonic diverticulitis. Alimentary Pharmacology & Therapeutics, 21: 889–897. doi: 10.1111/j.1365-2036.2005.02422.x
- Issue published online: 24 MAR 2005
- Article first published online: 24 MAR 2005
- Accepted for publication 29 January 2005
Background : There are no management criteria for optimum out-patient care in mild-to-moderate acute colonic diverticulitis.
Aim : To enable such patients to be managed in an out-patient setting, by establishing criteria and treatment protocols.
Methods : We conducted an open trial and follow-up study from 1997 to 2002. On the basis of ultrasonography, we defined and categorized mild-to-moderate acute colonic diverticulitis ranging from limited inflammation within diverticulum to an abscess < 2 cm in diameter. Subjects were treated as out-patients and followed a 10-day treatment protocol consisting of an oral antibiotic and a sports drink for the first 3 days. Physical examination and laboratory testing helped determine whether or not a patient could resume a liquid diet on day 4, and a regular diet on day 7.
Results : Of the 70 patients, 68 were successfully treated. Two patients required hospitalization. Of the 65 patients who were tracked over several months [median (intraquarter range) = 30.8 (11.9–44.2) months], 16 had one or more clinical recurrences. The medical cost per episode was 80% lower than in-patient treatment.
Conclusions : Patients with mild-to-moderate acute colonic diverticulitis can be safely and successfully treated as out-patients using this protocol.