Italian Study Group on Complicated Diverticulosis: The Natural History of Left-sided Acute Diverticulitis
Inclusion Criteria:
All consecutive patients with left sided acute diverticulitis diagnosed clinically by the
presence of:
- abdominal pain,
- leukocytosis (>11x109)
- fever >38°C and confirmed by imaging (CT scan, ultrasonography, water soluble
contrast enema)
The CT criteria for the diagnosis included at least one of:
- a localized thickening (≥4 mm) of the colonic wall
- signs of inflammation of the pericolic fat
- abscess
- extraluminal air
- extraluminal contrast
The ultrasound criteria included at least two of:
- bowel wall thickening (>4 mm)
- diverticular inflammation
- pericolic fat edema
- intramural or pericolic inflammatory mass
- intramural fistula
Water soluble contrast enema criteria included at least two of:
- segmental luminal narrowing
- a tethered mucosa
- a mass effect
- extravasation of contrast
- the presence of extraluminal air
Exclusion Criteria:
- inflammatory bowel disease
- irritable bowel syndrome
- colorectal cancer
- diseases precluding adequate follow up