Management of diverticulitis

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Abstract
Introduction The prevalence of perforated sigmoid diverticular disease in developed countries has increased from 2.4/100 000 in 1986 to 3.8/100 000 in 2000.1 Diverticular disease is one of the five most costly gastrointestinal disorders in the United States.2 Thirty years ago, the proportion of people who died from diverticular disease was decreasing.3 During the past 20 years, however, annual age standardised rates of admission and surgical intervention have increased by 16% from 20.1/100 000 to 23.2/100 000, whereas inpatient and population mortality remains unchanged.4 This increasing burden of disease means that clinicians in primary and secondary care will see increasing numbers of patients with diverticular disease and its complications. This review covers recent developments in the management of diverticular disease, including the current trend towards conservative rather than operative management after recovery from the initial episode.5