2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting

Massimo Sartelli,Ari Leppäniemi,Carlos Augusto Gomes,Gian Luigi De’ Angelis,Inés Rubio-Pérez ,Therèse M Duane ,Cui Y ,Sannop K Zachariah,Raúl Coimbra ,Offir Ben-Ishay,Timothy Craig Hardcastle ,Francesco M Labricciosa,Frederick A Moore,Kenji Inaba,Fikri M Abu‐Zidan ,Gabriele Sganga,Goran Augustin,Rodolfo Catena,Antonio Tarasconi,Dieter Weber ,Yoram Kluger,Konstantinos Bouliaris,Gustavo Pereira Fraga ,Jan Ulrych,Michael Mcfarlane,Rifat Latifi,Samir Delibegović ,Andrew W Kirkpatrick,Francesco Cortese,Marco Ceresoli,Matti Tolonen,Aleksandar Karamarković ,John E Mazuski,Andrey Litvin,Mário Paulo Faro ,Dimitrios Damaskos ,Osvaldo Chiara,Léonardo Pagani ,Vladimir Khokha,Norio Sato,Belinda De Simone,Kenneth Y Y Kok ,Ionuţ Negoi ,Sanjay Marwah,Boris Sakakushev,Francesco Di Marzo,Ernest E Moore,Walter Siquini,Zaza Demetrashvili,Walter L Biffl,Arda Işık ,Andreas Hecker,George Gkiokas,Federico Coccolini,Jeffry L Kashuk ,Kemal Raşa ,Luca Ansaloni,Salomone Di Saverio,Ronald V Maier,Massimo Chiarugi,Fausto Catena

doi:10.1186/s13017-020-00313-4

Abstract

Acute colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in the acute setting. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of acute left-sided colonic diverticulitis (ALCD) according to the most recent available literature. The update includes recent changes introduced in the management of ALCD. The new update has been further integrated with advances in acute right-sided colonic diverticulitis (ARCD) that is more common than ALCD in select regions of the world.

Highlights

Acute left-sided colonic diverticulosis is common in Western countries with its prevalence increasing throughout the world, which is likely due to changes in lifestyle [1]
Recent evidence suggests that lifetime risk of developing acute left-sided colonic diverticulitis (ALCD) is about 4% among patients with diverticulosis [3], and data from Western populations suggest that up to one fifth of patients with acute diverticulitis are under 50 years of age [4–6]
ALCD is a common problem encountered by Western surgeons in the acute setting

Summary

Introduction

Acute left-sided colonic diverticulosis is common in Western countries with its prevalence increasing throughout the world, which is likely due to changes in lifestyle [1]. Left-sided colonic diverticulosis remains more common among elderly patients, a dramatic rise of its incidence has been seen in younger age groups in recent years [2]. Recent evidence suggests that lifetime risk of developing acute left-sided colonic diverticulitis (ALCD) is about 4% among patients with diverticulosis [3], and data from Western populations suggest that up to one fifth of patients with acute diverticulitis are under 50 years of age [4–6]. ALCD is a common problem encountered by Western surgeons in the acute setting. The sigmoid colon is usually the most commonly involved part, while acute rightsided diverticulitis (ARCD) is rarer but much more common in non-Western populations

Methods

Generalized purulent peritonitis 4 Generalized fecal peritonitis

Findings

Conclusions