The out‐patient management of patients with acute mild‐to‐moderate colonic diverticulitis

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Abstract
Summary: Background : There are no management criteria for optimum out‐patient care in mild‐to‐moderate acute colonic diverticulitis.Aim : To enable such patients to be managed in an out‐patient setting, by establishing criteria and treatment protocols.Methods : We conducted an open trial and follow‐up study from 1997 to 2002. On the basis of ultrasonography, we defined and categorized mild‐to‐moderate acute colonic diverticulitis ranging from limited inflammation within diverticulum to an abscess < 2 cm in diameter. Subjects were treated as out‐patients and followed a 10‐day treatment protocol consisting of an oral antibiotic and a sports drink for the first 3 days. Physical examination and laboratory testing helped determine whether or not a patient could resume a liquid diet on day 4, and a regular diet on day 7.Results : Of the 70 patients, 68 were successfully treated. Two patients required hospitalization. Of the 65 patients who were tracked over several months [median (intraquarter range) = 30.8 (11.9–44.2) months], 16 had one or more clinical recurrences. The medical cost per episode was 80% lower than in‐patient treatment.Conclusions : Patients with mild‐to‐moderate acute colonic diverticulitis can be safely and successfully treated as out‐patients using this protocol.