Treatment Of Acute Diverticulitis Research Articles

FP1.5 - Safety and efficacy of Ambulatory treatment of uncomplicated acute diverticulitis: A two-centre cohort study and a proposal of an Ambulatory pathway

Abstract Aim This study aimed to assess the safety and efficacy of ambulatory treatment in patients with uncomplicated acute diverticulitis (AD) compared with inpatient treatment. Methods This is a retrospective comparative study conducted in two hospitals. All patients presented to the emergency department with CT-confirmed Hichney 1a AD during the period from 01/01/2022 to 31/12/2022 were included in this study. Patients with complicated diverticulitis or CT was not performed were excluded. All patients were followed for 12 months for re-admission and AD recurrence. Data analysis was performed with SPSS 27. Results A total of 137 patients were presented during the study period with CT-confirmed Hinchey 1a AD. The median age was 62 (24-94) years old, with a female-to-male ratio of 1.7:1. In the majority of patients (75.9%), WBCS was < 15 and CRP < 100. Moreover, 37.2% had previous AD, and it was complicated in 5.8%. For 12 months of follow-up, 19% of the cases developed diverticulitis recurrence. However, only 1 patient required surgery, and no patient required radiology intervention. No mortality was reported. A luminal investigation (CT colonoscopy or endoscopy) was organized in 61.3%, and colon cancer was detected in one patient. A comparison of patients who were treated as ambulatory (n=35) versus inpatient (n= 102) showed no significant difference regarding re-admission and recurrence of AD (P= 0.22) and surgical intervention (P=0.5) during 1-year follow-up. Conclusion With comparable results to inpatient treatment, the Ambulatory treatment of Hinchey 1a AD is safe and feasible and provides a reduction of treatment expenses.

Effectiveness of Treatment with Antibiotics Alone in Patients with Acute Diverticulitis and Pelvic Abscesses.

Introduction: The available evidence regarding the treatment of acute diverticulitis (AD) with pelvic abscess using antibiotics alone is very limited. The objective of this study was to determine whether the short- and long-term outcomes of AD with pelvic abscesses treated exclusively with antibiotics are comparable to those of pericolic abscesses. Methods: A retrospective study was conducted on patients diagnosed with AD and either pelvic or pericolic abscesses, as confirmed by computed tomography, who were treated solely with antibiotic therapy between 2011 and 2021. Cases involving percutaneous drainage as part of conservative treatment were excluded. Results: Fifty-eight patients met the inclusion criteria, comprising 12 with pelvic abscesses and 46 with pericolic abscesses. Both groups exhibited similar baseline characteristics and radiological findings, except for a more frequent presence of free fluid in pelvic abscesses. The success rate of antibiotic therapy was 91.7% for pelvic abscess cases and 96.7% for pericolic cases (p = 0.508). No significant differences were observed in recurrence or elective surgery. In the subgroup of abscesses with a diameter ≥4 cm, the evolution was similar in both locations (treatment success rate of 87.5% in pelvic and 94.4% in pericolic; p = 0.529), although recurrence was slightly higher for pericolic abscesses (38.4% vs. 14.3%; p = 0.362). Conclusions: Antibiotic therapy alone proves to be effective and safe for pelvic abscesses, demonstrating a course similar to pericolic abscesses, even in the case of large abscesses. Although the analyzed patient cohort is small, this study provides additional evidence that percutaneous drainage is not always essential for treating this complication.

Diverticulitis in the Under-40 Population.

As obesity and lifestyle factors become more prevalent in younger populations, we are diagnosing and treating diverticulitis in younger patients. In this study, the demographics, risk factors for the development, and treatment of acute diverticulitis were assessed focusing on patients under the age of 40. A retrospective review of the electronic medical records of a cohort of subjects diagnosed with diverticulitis was performed. Inclusion criteria included patients aged 18-40 who were treated for acute diverticulitis with or without any complications. Of the 109 patients, 40 patients required surgery, and 69 patients were managed conservatively. Analysis showed that the Hinchey classification (p<0.001) was the strongest predictor of treatment modality. As the incidence of diverticulitis has increased in recent decades, so too has the frequency with which elective surgical procedures are performed as treatment. While these procedures are vital components in the management of diverticulitis, the majority of research comparing conservative versus surgical treatments has been done in patients over 50 years old. Although diverticulitis has been classically thought of as a disease of the elderly, it has become more prevalent in younger populations due to the rise of obesity and lifestyle modification in the under-40 population. Although the prevalence of treatment and diagnosis of acute diverticulitis in younger patients has risen, there is a paucity of data surrounding treatment protocols for diverticulitis in association with patient symptoms for patients under the age of 40 years old. Our study has found that there is a higher incidence of complications in diverticulitis inpatients under the age of 40.Additionally, when considering the pattern of complication presentation in younger patients with complicated diverticulitis, surgical intervention might not be appropriate. The current treatment algorithm relates diverticulitis complications with surgical interventions. However, our data suggest that patients under the age of 40 presenting with abscesses or strictures may not need surgical intervention. This information could be particularly helpful in guiding physicians and younger patients in selecting the best choice of care and minimizing complications.Additionally, further research should help guide treatment protocol in this specific population of patients, as there is a lack of established guidelines pertaining to diverticulitis surrounding younger patients.

Acute Colonic Diverticulitis.

Acute colonic diverticulitis is a gastrointestinal condition that is frequently encountered by primary care and emergency department practitioners, hospitalists, surgeons, and gastroenterologists. Clinical presentation ranges from mild abdominal pain to peritonitis with sepsis. It is often diagnosed on the basis of clinical features alone, but imaging is necessary in more severe presentations to rule out such complications as abscess and perforation. Treatment depends on the severity of the presentation, the presence of complications, and underlying comorbid conditions. Medical and surgical treatment algorithms are evolving. This article provides an evidence-based, clinically relevant overview of the epidemiology, diagnosis, and treatment of acute diverticulitis.

Enfermedad diverticular

Diverticula are sac-like protrusions that appear in the weak points of the colon wall. They are usually asymptomatic. Diverticular disease develops when symptoms appear. Its etiopathogenesis is likely multifactorial, although it is not fully known. Complicated diverticulosis includes acute diverticulitis, which is the most frequent complication and one of the most common reasons for consultation in emergency departments, and diverticular hemorrhage, one of the most frequent causes of lower gastrointestinal bleeding in our setting. A diagnosis of acute diverticulitis is established through an abdominal computed tomography scan. A diagnosis of hemorrhage is established by performing a full colonoscopy, for which adequate prior preparation of the patient by means of taking an oral laxative solution is recommended. The treatment of acute diverticulitis has classically been based on the use of antibiotics, although current evidence supports a decrease in the use of antibiotic treatment in patients with uncomplicated acute diverticulitis. In this disease, antibiotics must target a polymicrobial etiology consisting mainly of gram-negative and anaerobic bacilli.

Diagnosis and management of acute colonic diverticulitis: results of a survey among Korean gastroenterologists.

Some management strategies for acute colonic diverticulitis remain controversial in Korean real-world practice because their clinical features differ from those in the West. This study aimed to investigate the opinions of Korean physicians regarding the diagnosis and treatment of acute diverticulitis. A web-based survey was conducted among gastroenterologists specializing on treating lower gastrointestinal disorders. The questionnaires concerned overall management strategies for colonic diverticulitis, including diagnosis, treatment, and follow-up. In total, 209 gastroenterologists responded to the survey. Less than one-fourth of the respondents (23.6%) answered that left-sided colonic diverticulitis is more likely to be complicated than right-sided colonic diverticulitis. Most respondents agreed that immunocompromised patients with diverticulitis have worse clinical outcomes than immunocompetent patients (71.3%). Computed tomography was the most preferred tool for diagnosing diverticulitis (93.9%). Approximately 89% of the respondents answered that they believed antibiotic treatment is necessary to treat acute uncomplicated diverticulitis. Most respondents (92.6%) agreed that emergency surgery is not required for diverticulitis with an abscess or microperforation without panperitonitis. Further, 94.7% of the respondents agreed that colon cancer screening is necessary in patients aged ≥ 50 years with diverticulitis after they have recovered from acute illness. Many respondents (71.4%) agreed that surgery for recurrent diverticulitis should be individualized. Opinions regarding management strategies for colonic diverticulitis among Korean gastroenterologists were well agreed upon in some areas but did not agree well in other areas. Evidence-based guidelines that meet the practical needs of the Korean population should be developed.

Study protocol for daiobotanpito combined with antibiotic therapy for treatment of acute diverticulitis: a study protocol for a randomized controlled trial

BackgroundColonic diverticular disease has been increasing in prevalence due to the rapidly aging global population, but standard treatment has not changed dramatically in recent years. Daiobotanpito (DBT; Da Huang Mu Dan Tang in Chinese) has been used in medical treatment of acute abdominal abscesses, such as appendicitis or diverticulitis in traditional Japanese (Kampo) medicine for many years, based on more than 3000 years of experience. Prior to this study, a retrospective open-label trial was conducted to compare patients with acute diverticulitis who received oral DBT combined with intravenous antibiotics with those who received intravenous antibiotic alone; it showed a positive effect of DBT on acute diverticulitis. We aim to investigate whether moderate to severe acute diverticulitis shows greater improvement with intravenous antibiotics plus orally administered DBT compared with intravenous antibiotics plus placebo.MethodsThis is a two-group, randomized, double-blind, placebo-controlled, multi-center trial, which is designed to evaluate the efficacy and safety of DBT in patients with moderate to severe diverticulitis treated with intravenous antibiotics. Eligible participants will be randomized to either a treatment group receiving a 10-day oral DBT regimen plus conventional therapy or a control group receiving a 10-day placebo regimen plus conventional therapy. The primary outcome will be success in treating diverticulitis: the success rate will be defined as elimination of abdominal pain within 4 days in all patients, and in patients with fever (body temperature ≧ 37.5 °C) on inclusion into this study, fever relief with reduction in body temperature to < 37.5 °C within 3 days. Secondary endpoints will include the number of hospitalization days, changes in inflammatory response (C-reactive protein (CRP), white blood cell (WBC) and neutrophil counts), fever type, number of days before beginning food intake, recurrence rate (observation for 1 year after registration), and adverse event expression rate. Assessments will be performed at baseline and on the day of discharge. The recurrence rate will be recorded at 1 year after registration.DiscussionThis study is expected to provide evidence to support the clinical benefits of DBT in the treatment of acute diverticulitis. It may also provide evidence on the efficacy and safety of DBT in the recurrence of acute diverticulitis.Trial registrationUMIN-CTR: UMIN000027381. Registered on 27 April 2017.https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000031377, and changed to jRCTs041180063, registered on 30 July 2019; as a result of the revision of the domestic law in 2018 in Japan.

Acute diverticulitis: old challenge, current trends, open questions.

Acute diverticulitis (AD) is an increasing issue for health systems worldwide. As accuracy of clinical symptoms and laboratory examinations is poor, a pivotal role in preoperative diagnosis and severity assessment is played by CT scan. Several new classifications trying to adapt the intraoperative Hinchey's classification to preoperative CT findings have been proposed, but none really entered clinical practice. Treatment of early AD is mostly conservative (antibiotics) and may be administered in outpatients in selected cases. Larger abscesses (exceeding 3 to 5 cm) need percutaneous drainage, while management of stages 3 (purulent peritonitis) and 4 (fecal peritonitis) is difficult to standardize, as various approaches are nowadays suggested. Three situations are identified: situation A, stage 3 in stable/healthy patients, where various options are available, including conservative management, lavage/drainage and primary resection/anastomosis w/without protective stoma; situation B, stage 3 in unstable and/or unhealthy patients, and stage 4 in stable/healthy patients, where stoma-protected primary resection/anastomosis or Hartmann procedure should be performed; situation C, stage 4 in unstable and/or unhealthy patients, where Hartmann procedure or damage control surgery (resection without any anastomosis/stoma) are suggested. Late, elective sigmoid resection is less and less performed, as a new trend towards a patient-tailored management is spreading.

Methicillin-resistant Staphylococcus Aureus Colitis Secondary to Complicated Acute Diverticulitis: A Rare Case Report

A 33-year-old obese female with a recent diagnosis of acute diverticulitis (AD) was admitted to the hospital for severe abdominal pain, intractable nausea and vomiting, and diarrhea two days following oral antibiotic treatment for AD. Stool cultures collected upon her readmission were negative for Clostridium difficile (C. difficile) antigen and toxins A and B, but were notable for methicillin-resistant Staphylococcus aureus (MRSA). She was started on intravenous (IV) piperacillin/tazobactam, IV vancomycin, and an oral liquid vancomycin solution, which resulted in rapid resolution of her symptoms. Unfortunately, her symptoms recurred two weeks later and she eventually underwent laparoscopic low anterior resection (LAR) of her colon for continued diverticulitis. This resulted in complete and continued resolution of her symptoms.

Surgical Treatment of Diverticulitis

Surgical evaluation and treatment is commonly required for the treatment of diverticulitis in both the acute and elective situations. This chapter discusses the surgical treatment of the clinically important manifestations of diverticular disease. Different options for surgical treatment are described for patients in both the urgent and elective settings, including technical aspects of these options. Current controversies are reviewed, including resection versus laparoscopic lavage for the treatment of purulent peritonitis, the use of gastrointestinal diversion in the surgical treatment of acute diverticulitis, and timing of operation for recurrent diverticulitis. This review contains 8 figures, 4 tables, and 67 references. Key Words: acute diverticulitis, complicated diverticulitis, diverticular disease, diverticulitis, diverticulosis, Hartmann procedure, laparoscopic lavage, sigmoid resection with primary anastomosis, uncomplicated diverticulitis

Diagnosis and Management of Acute Diverticulitis

Diverticulitis is the cause of 300,000 inpatient admissions in the United States each year. Surgical evaluation and treatment are commonly required for the treatment of diverticulitis. This chapter discusses the diagnosis, triage, and treatment of acute diverticulitis. Medical treatment, as well as the indications for surgical treatment for diverticulitis, is discussed. Current controversies, including the need for antibiotics for a patient with acute uncomplicated diverticulitis, necessity of colonoscopy after resolution of an acute episode, and indications for urgent surgery, are reviewed. This review contains 10 figures, 3 tables, and 67 references. keywords: acute diverticulitis, colonic fistula, complicated diverticulitis, diverticular abscess, diverticular disease, diverticulitis, diverticulosis, perforated diverticulitis, uncomplicated diverticulitis

Is the outpatient management of acute diverticulitis safe and effective? A systematic review and meta-analysis.

In Western countries, the incidence of acute diverticulitis (AD) is increasing. Patients with uncomplicated diverticulitis can undergo a standard antibiotic treatment in an outpatient setting. The aim of this systematic review was to assess the safety and efficacy of the management of acute diverticulitis in an outpatient setting. A literature search was performed on PubMed, Scopus, Embase, Central and Web of Science up to September 2018. Studies including patients who had outpatient management of uncomplicated acute diverticulitis were considered. We manually checked the reference lists of all included studies to identify any additional studies. Primary outcome was the overall failure rates in the outpatient setting. The failure of outpatient setting was defined as any emergency hospital admission in patients who had outpatient treatment for AD in the previous 60 days. A subgroup analysis of failure was performed in patients with AD of the left colon, with or without comorbidities, with previous episodes of AD, in patients with diabetes, with different severity of AD (pericolic air and abdominal abscess), with or without antibiotic treatment, with ambulatory versus home care unit follow-up, with or without protocol and where outpatient management is a common practice. The secondary outcome was the rate of emergency surgical treatment or percutaneous drainage in patients who failed outpatient treatment. This systematic review included 21 studies including 1781 patients who had outpatient management of AD including 11prospective, 9 retrospective and only 1 randomized trial. The meta-analysis showed that outpatient management is safe, and the overall failure rate in an outpatient setting was 4.3% (95% CI 2.6%-6.3%). Localization of diverticulitis is not a selection criterion for an outpatient strategy (p 0.512). The other subgroup analyses did not report any factors that influence the rate of failure: previous episodes of acute diverticulitis (p = 0.163), comorbidities (p = 0.187), pericolic air (p = 0.653), intra-abdominal abscess (p = 0.326), treatment according to a registeredprotocol (p = 0.078), type of follow-up (p = 0.700), type of antibiotic treatment (p = 0.647) or diabetes (p = 0.610). In patients who failed outpatient treatment, the majority had prolonged antibiotic therapy and only few had percutaneous drainage for an abscess (0.13%) or surgical intervention for perforation (0.06%). These results should be interpreted with some caution because of the low quality of available data. The outpatient management of AD can reduce the rate of emergency hospitalizations. This setting is already part of the common clinical practice of many emergency departments, in which a standardized protocol is followed. The data reported suggest that this management is safe if associated with an accurate selection of patients (40%); but no subgroup analysis demonstrated significant differences between groups (such as comorbidities, previous episode, diabetes). The main limitations of the findings of the present review concern their applicability in common clinical practice as it was impossible to identify strict criteria of failure.

Current Recommendations on Treatment of Acute Diverticulitis – Mini Review

Diverticulosis is a common disease in Western world and is associated with a Western lifestyle with low fiber diet, smoking, constipation. It is quite rare in the East, however it’s incidence is growing also in the Eastern countries. Diverticula are a small outpouching of the colonic wall and are harmless, unless they became inflammed or cause other symptoms. Colonic diverticula can occur anywhere in the colon or rectum, but they most often occur in the descending and sigmoid colon [1]. The majority of individuals (80-85%) with colonic diverticula remain asymptomatic, 10-15% of people with colonic diverticulosis develop abdominal symptoms, such as abdominal pain, bloating or changes in bowel habits.

Current Recommendations on Treatment of Acute Diverticulitis -Mini Review

Diverticulosis is a common disease in Western world and is associated with a Western lifestyle with low fiber diet, smoking, constipation...

Acute Colonic Diverticulitis.

Acute colonic diverticulitis is a gastrointestinal condition frequently encountered by primary care practitioners, hospitalists, surgeons, and gastroenterologists. Clinical presentation ranges from mild abdominal pain to peritonitis with sepsis. It can often be diagnosed on the basis of clinical features alone, but imaging is necessary in more severe presentations to rule out such complications as abscess and perforation. Treatment depends on the severity of the presentation, presence of complications, and underlying comorbid conditions. Medical and surgical treatment algorithms are evolving. This article provides an evidence-based, clinically relevant overview of the epidemiology, diagnosis, and treatment of acute diverticulitis.

Treatment of diverticular disease: an update on latest evidence and clinical implications.

BackgroundDiverticular disease (DD) is a common condition, especially in Western countries. In about 80% of patients, colonic diverticula remain asymptomatic (diverticulosis), while approximately 20% of patients may develop abdominal symptoms (symptomatic uncomplicated diverticular disease, SUDD) and, eventually complications as acute diverticulitis (AD). The management of this condition has been improved, and in the last five years European countries and the USA have published guidelines and recommendations.ScopeTo summarize the latest evidence and clinical implication in treatment of DD focusing the attention either on the treatment of diverticulosis, SUDD and AD together with the primary and secondary prevention of diverticulitis.FindingsThe present review was based on the latest evidence in the treatment of DD in the last 10 years. In the last 5 years, six countries issued guidelines on DD with differences regarding covered topics and recommendations regarding treatments. At present there is a lack of rationale for drug use in patients with asymptomatic diverticulosis, but there are limited indications to suggest an increase in dietary fibre to reduce risk of DD. To achieve symptomatic relief in SUDD patients, several therapeutic strategies with fibre, probiotics, rifaximin and mesalazine have been proposed even if a standard therapeutic approach remained to be defined. Agreement has been reached for the management of AD, since recent guidelines showed that antibiotics can be used selectively, rather than routinely in uncomplicated AD, although use of antibiotics remained crucial in the management of complicated cases. With regard to treatment for the primary and secondary prevention of AD, the efficacy of rifaximin and mesalazine has been proposed although with discordant recommendations among guidelines.ConclusionTreatment of DD represented an important challenge in clinical practice, especially concerning management of SUDD and the primary and secondary prevention of AD.

Is it safe and useful, laparoscopic peritoneal lavage in the treatment of acute diverticulitis of octogenarian patients? A multicenter retroprospective observational study.

Diverticular disease of the colon also affects older people. Generally, older patients with diverticulitis may be regarded as too risky to undergo surgery. This retroprospective multicentric observational study aims to assess the safety and benefits of laparoscopic peritoneal lavage (LPL) in elderly patients with perforated sigmoid diverticulitis. We hospitalized in urgency 100 patients, aged over 75, for sigmoid diverticulitis. Sixty-nine patients were treated with conservative medical therapy, while 31 were treated surgically, in which the surgery was performed in urgency in 18 cases, while in election in 13 cases. Laparoscopic peritoneal lavage was made in urgency in five cases. The mean age of the sample was 81.72. Thirty-one patients underwent surgery, and five patients were treated in urgency with laparoscopic peritoneal lavage. Perioperative mortality was zero. None of the patients who underwent laparoscopic peritoneal lavage showed recurrent disease. Diagnostic laparoscopy can be useful in elderly patient, since these patients may benefit from a more conservative surgical strategy. The selection of patients to be subjected to laparoscopic lavage must be very rigorous.

Akut divertikülitin tedavi yönetiminde değişim

Objective: Acute diverticulitis is a common disease of western society and it is gradually increasing in frequency. Although its etiology, natural course, complications and diagnostic methods are defined, there is no agreement in the literature on which treatment option should be implemented. Nonoperative approaches in the treatment of acute diverticulitis are coming into prominence in recent years. Parallel with the discussions in the literature, we aim to present changes in our clinical approach to acute diverticulitis in last 5 years. Material and Methods: Patients admitted to our clinic with acute abdomen and diagnosed as acute diverticulitis and treated between January 2010 and February 2016 were analyzed retrospectively. The demographic characteristics of the patients, radiological findings, treatment modalities (medical / surgical), length of hospital stay, morbidity and mortality rates were evaluated. Results: Of 106 patients, 67 (63.2%) were male and mean age was 54.3 (27-87). The average length of hospital stay was 4.4 days (range 1-18). 79.2% of patients were governed medically and 20.8% of pantients were treated with a surgical procedure. The mean follow-up period was 28 months (range 15-39). When the number of applications are considered, surgical approaches in treatment are found to be reduced to appropriate levels proportional to the treatment modalities of modern age. Conclusion: Nonoperative approach in uncomplicated acut diverticulitis is an effective and reliable method. In complicated diverticulitis, surgical techniques , primarily nonresectional approaches, can be applied.

PWE-104 A Randomised Double-Blind Placebo-Controlled Trial of A Multi-Strain Probiotic in The Treatment of Chronic Symptoms Post Diverticulitis

Introduction The emergency treatment for acute diverticulitis is straightforward, but many patients develop post-diverticulitis chronic symptoms which resemble that of Irritable Bowel Syndrome (IBS). We assessed the possible effect of Symprove, a multi strain probiotic, on these symptoms in a randomised double-blind placebo-controlled trial. Methods This was a single-centre, randomised, double-blind, placebo-controlled trial of the efficacy of the probiotic Symprove in adult patients with post-diverticulitis IBS like symptoms. 143 patients were randomly assigned to receive 1 mL/kg/day of the probiotic (N = 72) or placebo (N = 71) for 3 months. The primary endpoint was a change in abdominal pain. Secondary endpoints included nine abdominal symptoms and changes in faecal calprotectin. Results 120 patients completed the trial. Pain score with the probiotic decreased from 9.5±7.7 to 5.9±6.7, which did not differ significantly ( P = 0.12) with that of placebo (7.5±7.0 to 6.1±6.4). The probiotic improved constipation, diarrhoea, mucorrhoea, back pain and vaginal discharge significantly (p p = 0.05) Conclusion The probiotic Symprove did not improve abdominal pain scores significantly, but significantly improved some other post-diverticulitis symptoms and prevented an escalation in intestinal inflammatory activity in male patients. Disclosure of Interest C. Kvasnovsky: None Declared, A. Donaldson: None Declared, R. Sherwood: None Declared, I. Bjarnason Grant/research support from: Received financial support for a SpR for a PhD student (Charlotte), S. Papagrigordiasis Grant/research support from: Recipent of a grant from Symprove for a PhD studentship (Charlotte)

Short-term mortality, readmission, and recurrence in treatment of acute diverticulitis with abscess formation: a nationwide register-based cohort study.

The aim of the study was to investigate short-term mortality, readmission, and recurrence in a national cohort of patients with Hinchey Ib-II diverticulitis. The retrospective cohort-investigation was conducted using a database consisting of the entire Danish population (n = 6,641,672) in year 2000-2012, formed by linking the Danish Registers. Patients admitted with acute Hinchey Ib-II diverticulitis were identified from ICD-10 discharge codes and stratified according to treatment into an operative, drainage, and antibiotics group. The primary outcome was 30-day mortality from admission, secondary outcomes were mortality, readmission, and recurrence within 30days post-discharge. The study was reported using RECORD guidelines. A total of 3148 eligible patients were identified. The cohort had a mean age of 65.1year, 25.6% had previously been admitted with diverticulitis, and 48.1% had registered comorbidities. Within 30days from admission, 8.7% of the patients died. Of patients discharged, 2.5% died, 23.8% was readmitted, and 5.9% was readmitted due to diverticulitis within 30days from discharge. In multivariate analyses, increasing age was associated with mortality at odds-ratio (95% CI) 1.10 (1.09-1.12). Previous complicated and uncomplicated diverticulitis reduced mortality with odds-ratio 0.50 (0.33-0.76) and 0.73 (0.58-0.92), while uncomplicated diverticulitis also increased risk of recurrence with odds-ratio 1.51 (1.24-1.84). Glucocorticoid usage was associated with mortality with odds-ratio 1.49 (1.23-1.81) and readmission with odds-ratio 2.91 (1.24-6.80). Acute diverticulitis with abscess formation is a severe and life-threatening condition. Direct comparisons of treatment groups were not possible due to possible confounding by indication.