Trial reportJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019
Conservative Treatment in Diverticulitis Patients with Pericolic Extraluminal Air and the Role of Antibiotic Treatment.
Trial report in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- The role of non-operative management (NOM) in perforated diverticulitis: a systematic review.Langenbeck's archives of surgery · 2026Pooled it
- SAGES white paper on antibiotic omission in the management of acute uncomplicated diverticulitis: why, when, who, and most importantly, how.Surgical endoscopy · 2025Guideline
- German guideline diverticular disease/diverticulitis: Part II: Conservative, interventional and surgical management.United European gastroenterology journal · 2022Guideline
- 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
- Surveillance and follow-up in acute diverticulitis with pericolic free gas (ADiFas II): an age-specific analysis.Updates in surgery · 2025Article
- Evidence-based, cost-effective management of acute diverticulitis. An algorithm of the Journal of Trauma and Acute Care Surgery emergency general surgery algorithms work group.The journal of trauma and acute care surgery · 2025Article
- C-reactive protein and digestive pathologies: A narrative review for daily clinical use.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2025Review
- A novel scoring system for predicting disease severity without CT imaging in acute diverticulitis.International journal of colorectal disease · 2024Article
- Acute diverticulitis with extraluminal air: is conservative treatment sufficient? A single-center retrospective study.Techniques in coloproctology · 2024Article
- Management of acute diverticulitis in Stage 0-IIb: indications and risk factors for failure of conservative treatment in a series of 187 patients.Scientific reports · 2024Article
- Drains, Germs, or Steel: Multidisciplinary Management of Acute Colonic Diverticulitis.Digestive diseases and sciences · 2020Review
- The clinical significance of extraluminal air in Hinchey 1a diverticulitis: results from a retrospective cohort study with 10-year follow-up.International journal of colorectal disease · 2019Observational
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecently published studies advocate a conservative approach with observation and antibiotic treatment in diverticulitis patients with pericolic air on computed tomography (CT). The primary aim of this study was to assess the clinical course of initially conservatively treated diverticulitis patients with isolated pericolic air and to identify risk factors for conservative treatment failure. The secondary aim was to assess the outcome of non-antibiotic treatment.
methodsPatient data from a retrospective cohort study on risk factors for complicated diverticulitis were combined with data from the DIABOLO trial, a randomised controlled trial comparing non-antibiotic with antibiotic treatment in patients with uncomplicated diverticulitis. The present study identified all patients with Hinchey 1A diverticulitis with isolated pericolic air on CT. Pericolic air was defined as air located < 5 cm from the affected segment of colon. The primary outcome was failure of conservative management which was defined as need for percutaneous abscess drainage or emergency surgery within 30 days after presentation. A multivariable logistic regression of clinical, radiological and laboratorial parameters with respect to treatment failure was performed.
resultsA total of 109 patients were included in the study. Fifty-two (48%) patients were treated with antibiotics. Nine (8%) patients failed conservative management, seven (13%) in the antibiotic treatment group and two (4%) in the non-antibiotic group (p = 0.083). Only (increased) CRP level at presentation was an independent predictor for treatment failure.
conclusionsConservative treatment in diverticulitis patients with isolated pericolic air is a suitable treatment strategy. Moreover, non-antibiotic treatment might be reasonable in selected patients.
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