ArticleTechniques in coloproctology2015
Antibiotics alone instead of percutaneous drainage as initial treatment of large diverticular abscess.
Article in Techniques in coloproctology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Failure of nonoperative management in patients with acute diverticulitis complicated by abscess: a systematic review.International journal of colorectal disease · 2021Pooled it
- 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting.World journal of emergency surgery : WJES · 2020Guideline
- Evidence-based clinical practice guidelines for diagnosis and medical management of acute colonic diverticulitis developed by the Korean Association for the Study of Intestinal Diseases (KASID).Intestinal research · 2026Review
- Predictive factors for conservative treatment failure of acute complicated diverticulitis: a single-center retrospective analysis.Updates in surgery · 2026Article
- Does localization change management in complicated right and left-sided diverticulitis?World journal of gastrointestinal surgery · 2025Article
- Direction of perforation predicts the failure of non-operative management in patients with acute diverticulitis.Langenbeck's archives of surgery · 2025Article
- Clinical relevance of the 3-cm threshold in sigmoid diverticulitis with abscess: consensus or quandary?International journal of colorectal disease · 2024Article
- Towards a tailored approach for patients with acute diverticulitis and abscess formation. The DivAbsc2023 multicentre case-control study.Surgical endoscopy · 2024Article
- Curative resection after percutaneous drainage followed by preoperative panitumumab monotherapy for locally advanced sigmoid colon cancer with intra-abdominal abscess: a case report.Surgical case reports · 2024Article
- Conservative management of complicated colonic diverticulitis: long-term results.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Guidelines for the Treatment of Abdominal Abscesses in Acute Diverticulitis: An Umbrella Review.Journal of clinical medicine · 2023Review
- Tobacco Smoking Is a Strong Predictor of Failure of Conservative Treatment in Hinchey IIa and IIb Acute Diverticulitis-A Retrospective Single-Center Cohort Study.Medicina (Kaunas, Lithuania) · 2023Article
- Outcomes of surgical treatment of diverticular abscesses after failure of antibiotic therapy.Updates in surgery · 2023Article
- [Recommendations for treatment of diverticular disease].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2020Review
- The Indications for and Timing of Surgery for Diverticular Disease.Deutsches Arzteblatt international · 2020Review
- Determinants of treatment and outcomes of diverticular abscesses.World journal of emergency surgery : WJES · 2019Article
- Current Options for the Emergency Management of Diverticular Disease and Options to Reduce the Need for Colostomy.Clinics in colon and rectal surgery · 2018Review
- Inflammation management in acute diverticulitis: current perspectives.Journal of inflammation research · 2018Review
- Short-term mortality, readmission, and recurrence in treatment of acute diverticulitis with abscess formation: a nationwide register-based cohort study.International journal of colorectal disease · 2016Article
- WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting.World journal of emergency surgery : WJES · 2016Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are limited data assessing the effectiveness of antibiotics as sole initial therapy in patients with large diverticular abscess. The aim of our study was to compare outcomes of selected patients treated with initial antibiotics alone versus percutaneous drainage.
methodsAll patients with diverticular abscess ≥3 cm in diameter treated in our institution in 1994-2012 with percutaneous drainage or antibiotics alone followed by surgery were identified from an institutional diverticular disease database. Groups were compared based on patient and disease characteristics, treatment failures and postoperative outcomes.
resultsThirty-two patients were treated with antibiotics alone because of either technically impossible percutaneous drainage (n = 15) or surgeon preference (n = 17) while 114 underwent percutaneous drainage. Failure of initial treatment required urgent surgery in 8 patients with persistent symptoms during treatment with antibiotics alone (25 %) and in 21 patients (18 %) after initial percutaneous drainage (p = 0.21). Reasons for urgent surgery after percutaneous drainage were persistent symptoms (n = 16), technical failure of percutaneous drainage (n = 4) and small bowel injury (n = 1). Patients treated with antibiotics had a significantly smaller abscess diameter (5.9 vs. 7.1 cm, p = 0.001) and shorter interval from initial treatment to sigmoidectomy (mean 50 vs. 80 days, p = 0.02). The Charlson comorbidity index, initial treatment failure rates, postoperative mortality, overall morbidity, length of hospital stay during treatments, and overall and permanent stoma rates were comparable in the two groups. Postoperative complications following antibiotics alone were significantly less severe than after percutaneous drainage based on the Clavien-Dindo classification (p = 0.04).
conclusionsSelected patients with diverticular abscess can be initially treated with antibiotics without adverse consequences on their outcomes.
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