Diverticular Disease

Abstract

Diverticulitis represents a broad spectrum of presentations ranging from mild left lower-quadrant pain to free perforation with peritonitis. A number of different modalities have been used to evaluate patients with suspected diverticular disease, but computed tomography (CT) has emerged as the study of choice. A number of behavioral and dietary risk factors have been identified. The surgical management of diverticular disease has changed substantially both in approach and timing of the index operation. While early operation after two uncomplicated attacks of diverticular disease was once common, it is now recommended that these decisions be made on an individual basis and incorporate a number of patient factors. Most patients with complicated presentations of diverticulitis will require an operation, but the necessity of surgery following certain complications (abscess) has been questioned. With increased adoption of minimally invasive surgical approaches, laparoscopic surgery has played a larger role in the management of diverticular disease.