Diverticulitis is a complication to the common condition diverticulosis. Uncomplicated diverticulitis has traditionally been treated with antibiotics. Risk factors for diverticulitis, however, may suggest, that the condition is inflammatory rather than infectious. The evidence on antibiotic treatment for uncomplicated acute diverticulitis suggests, that antibiotics have no effect on complications, emergency surgery, recurrence, elective colonic resections and long-term complications. The evidence is based on three randomised clinical trials on the need for antibiotics, which is summarised in this review.
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Antibiotics (Basel)
December 2024
Department of Microbiology, "Cantacuzino" Institute, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Antimicrobial resistance is one of the main threats to public health, with multidrug-resistant (MDR) pathogens on the rise across continents. Although treatment guidelines generally recommend antimicrobial therapy for acute complicated diverticulitis, they do not specify treatment pathways according to local or national resistance profiles. There is sparse data regarding specific pathogens involved in Hinchey II-IV patients who undergo surgery.
View Article and Find Full Text PDFAm J Emerg Med
December 2024
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:
Background: Recent studies have validated the efficacy of point-of-care ultrasound (POCUS) as an alternative diagnostic imaging approach to computed tomography (CT) for patients with suspected acute diverticulitis. This study aimed to quantify the national impact of this approach in cost savings, ED length-of-stay (LOS), and radiation risk mitigation using a POCUS-first approach for acute diverticulitis in the emergency department (ED).
Methods: Using published data, we constructed a Monte Carlo simulation model to compare two POCUS-first strategies (nonselective and selective approaches) for evaluating patients with suspected acute diverticulitis in the ED.
Biosci Microbiota Food Health
September 2024
Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
Why patients with symptomatic uncomplicated diverticular disease (SUDD) may develop acute diverticulitis (AD) is still unknown. We analyzed the gut microbiota (GM) in two SUDD patients, one who did experience SUDD recurrence but not AD occurrence (case 1) and one who did experience AD occurrence during follow-up (case 2). The GM of these patients showed differences in terms of phyla (Firmicutes and Bacteroidota in case 1; Actinobacteriota and Proteobacteria in case 2) and subgenera ( and in case 1 and , , , , group, and in case 2).
View Article and Find Full Text PDFCureus
December 2024
Trauma and Acute Care Surgery, Prince Sultan Military Medical City, Riyadh, SAU.
Jejunal diverticulum perforation is a rare condition and presents diagnostic challenges. A 41-year-old male presented to the emergency room with a history of vague, generalized, and continuous abdominal pain for two days. He was vitally stable; however, the abdominal examination revealed a soft and distended abdomen with positive rebound tenderness.
View Article and Find Full Text PDFCureus
December 2024
Surgical Oncology, Prince Sultan Military Medical City, Riyadh, SAU.
Small intestinal diverticula induced by malignant mesenchymal tumors are extremely rare clinical entities. We present the case of a 46-year-old female who reported a one-week history of worsening generalized abdominal pain accompanied by constipation. A computed tomography (CT) scan of her abdomen revealed an ulcerative mass at the proximal/midjejunal junction, suggestive of jejunal diverticulitis.
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