Diverticular disease and timing of surgery: Gastroenterologist and surgeon compared

Colon diverticulosis is a high prevalence clinical condition in western world. About 15% of patients with colonic diverticula will develop diverticular disease, a group of conditions that vary from a simple abdominal pain associated with changing in frequency or appearance of stool, to acute diverticulitis. An accurate diagnosis and stadiation are mandatory in acute diverticulitis, TC scan is the gold standard for evaluate the presence of complications. Uncomplicated diver-ticulitis do not routinely necessitate hospitalization. Patients with abscesses need intravenous antibiotics treatment; larger abscess may require a percutaneous drainage. Colonic perforation, diffuse peritonitis, sepsis and lack of response to antibiotic treatments or percutaneous drainage are indications for urgent surgery. Elective surgery is indicated in case of fistula to the urogenital tract or symptomatic colonic stenosis, and may be considered in selected patients, for secondary prophylaxis, taking into account benefits and risks.