Laparoscopic sigmoidectomy for recurrent diverticulitis with colouterine fistula

Recent evidence showed that dietary habits play a role as risk factors for the development of diverticular complications. This systematic review aims to assess the effect of dietary habits in the prevention of diverticula complications (i.e., acute diverticulitis and diverticula bleeding) in patients with diverticula disease. PubMed and Scopus databases were searched up to 19 January 2021, 330 records were identified, and 8 articles met the eligibility criteria and were subjected to data extraction. The quality of the studies was evaluated by the Newcastle-Ottawa quality assessment form. No study meets the criteria for being a high-quality study. A high intake of fiber was associated to a decreased risk of diverticulitis or hospitalization due to diverticular disease, with a protective effect for fruits and cereal fiber, but not for vegetable fiber; whereas, a high red meat consumption and a generally Western dietary pattern were associated with an increased risk of diverticulitis. Alcohol use seemed to be associated to diverticular bleeding, but not to recurrent diverticulitis or diverticular complications. Further high-quality studies are needed to better define these associations. It is mandatory to ascertain the role of dietary habits for the development of recurrent acute diverticulitis and diverticular bleeding.

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A case report of colouterine fistula due to colonic diverticulitis: a rare complication

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00301-3 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Shweta Pandey ◽

Saurabh Maheshwari ◽

Uddandam Rajesh ◽

Darshan Singh Grewal ◽

Vibhuti Maria

Keyword(s):

Case Report ◽

Rare Complication ◽

Colonic Diverticulitis ◽

Colouterine Fistula

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Management of colonic diverticulitis

BMJ ◽

10.1136/bmj.n72 ◽

2021 ◽

pp. n72

Author(s):

Anne F Peery

Keyword(s):

Gastrointestinal Disease ◽

Acute Diverticulitis ◽

Anaerobic Bacteria ◽

Gastrointestinal Symptoms ◽

Colon Resection ◽

Acute Onset ◽

Colonic Diverticulitis ◽

Uncomplicated Diverticulitis ◽

Recurrent Diverticulitis ◽

Primary Resection And Anastomosis

ABSTRACT Left sided colonic diverticulitis is a common and costly gastrointestinal disease in Western countries, characterized by acute onset of often severe abdominal pain. Imaging is necessary to make an initial diagnosis and determine disease severity. Colonoscopy should be done six to eight weeks after diagnosis to rule out a missed colon malignancy. Antibiotic treatment is used selectively in immunocompetent patients with mild acute uncomplicated diverticulitis. The clinical course of diverticulitis commonly includes unpredictable recurrences and chronic gastrointestinal symptoms, which are a detriment to quality of life. A better understanding of prognosis has prompted a shift toward non-operative approaches. The decision to undergo prophylactic colon resection should be individualized to consider the severity of diverticulitis, the patient’s health and immune status, and the patient’s preferences and values, as well as benefits and risks. Because only a section of colon is removed, recurrent diverticulitis remains a risk. Acute diverticulitis with an abscess is treated with antibiotics that cover Gram negative and anaerobic bacteria, with or without percutaneous drainage. Acute diverticulitis with purulent or feculent contamination of the peritoneal cavity is managed with surgery; primary resection and anastomosis is the procedure of choice in stable patients.

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