Abstract
Right colonic diverticulitis (RCD) and left colonic diverticulitis (LCD) may have different clinical features due to the different embryologic origins and anatomical locations of each colon. Therefore, we aimed to compare RCD and LCD in terms of the associated clinical features. We retrospectively collected clinical data from patients who were diagnosed with acute colonic diverticulitis based on computed tomography findings between 2011 and 2017. RCD was defined as colonic diverticulitis extending from the caecum to the transverse colon, and LCD was defined as extending from the splenic flexure to the sigmoid colon. These analyses included 667 patients with RCD and 58 patients with LCD. Relative to the patients with LCD, the patients with RCD were younger (P < 0.001), were more likely to be male (P = 0.033), were taller (P < 0.001), had lower body mass index values (P < 0.001), had less advanced modified Hinchey stages (P < 0.001), and had shorter hospital stays (P < 0.001). Having LCD rather than RCD was a predictor of recurrent colonic diverticulitis (P = 0.003). Relative to LCD, RCD occurs at younger ages, is expressed at less advanced modified Hinchey stages, and is associated with lower risks of recurrence.
Highlights
The clinical importance of colonic diverticulitis has been emphasised in the literature because the incidence of colonic diverticulitis has been increasing worldwide[1]
The left and right colons have different embryologic origins, with the left colon originating from the hindgut and the right colon originating from the midgut[8]
We considered all patients who were diagnosed with acute colonic diverticulitis based on computed tomography (CT) findings at our hospital between January 2011 and December 2017
Summary
The clinical importance of colonic diverticulitis has been emphasised in the literature because the incidence of colonic diverticulitis has been increasing worldwide[1]. Several studies have been conducted to evaluate left colonic diverticulitis (LCD) and identify the best treatment strategy because it is common in Western populations[2,3]. Right colonic diverticulitis (RCD) is rare in Western populations but common in Asian populations[4,5]. Despite its prevalence in Asian populations, few studies have investigated the clinical course of RCD or sought to identify the best treatment strategy. The algorithm recommends that only patients with complicated diverticulitis undergo surgery. The medical literature contains few cases of RCD in Asian patients for whom complicated diverticulitis was an indication for surgery[7]. A few studies have compared RCD and LCD, but these studies have been severely limited by their small sample sizes[9,10]. We aimed to perform a similar study with a larger sample size
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