SynthesisLangenbeck's archives of surgery2026
The role of non-operative management (NOM) in perforated diverticulitis: a systematic review.
Synthesis in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Possible underestimation of non-operative management success in perforated diverticulitis with distant free air : Re: Cirocchi R, Matteucci M, Mari GM et al. (2026) The role of non-operative management (NOM) in perforated diverticulitis: a systematic review. Langenbecks Arch Surg 411:79.Langenbeck's archives of surgery · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOne of the most common and significant complication of acute diverticulitis is visceral perforation. Current clinical guidelines suggest conservative medical therapy can be adopted for selected patients with perforation, especially those with pericolic air, while its role remains less clear in cases of distant air. The aim of our study is to evaluate the role of non-operative management (NOM) in case of pericolic and distant air. MATERIALS AND
methodsThe authors conducted a comprehensive literature review; this search yielded 23 studies (17 retrospective, 5 prospective and 1 randomized control trial), including 2689 patients.
resultsConservative management of patients with air in perforated diverticulitis was safe and feasible, with a overall pooled success rate of 90.2% (95% CI: 86.4-93). Specifically, among patients with pericolic extraluminal air, the success rate of NOM was 89.9%. In contrast, the role of NOM in cases with distant free air remains uncertain, with a lower success rate of only 27.8%.
conclusionNon-operative management (NOM) appears safe and effective for patients with perforated diverticulitis and pericolic extraluminal air, provided there are no clinical signs of generalized peritonitis. In contrast, its role in cases with distant free air is highly uncertain: the pooled success rate is lower, even among hemodynamically stable patients. Based on these findings, early surgical management should be strongly considered for patients with distant free air, while NOM should only be attempted in highly selected cases under strict clinical and radiological monitoring. Conversely, NOM can be confidently recommended for patients with pericolic air who are stable and without diffuse peritonitis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.