| Abstract [eng] |
Aim of Research. To analyze the newest guidelines on the topic of diagnostics and treatment of acute diverticulitis and to provide diagnostics‘ and treatment of the acute diverticulitis recommendations based on the reviewed guidelines. Objectives. 1. To distinguish first choice diagnostic modalities of the acute diverticulitis in the newest scientific literature. 2. To determine and review the most common conservative and surgical treatment options in complicated and uncomplicated acute diverticulitis. 3. To provide diagnostics‘ and treatment of the acute diverticulitis recommendations over which there is a concordance among the majority of the guidelines. Methods. A selection and review of the newest acute diverticulitis diagnostics and treatment guidelines was made using the PubMed database in English and German languages over the period from 2012 to 2022 with the guidance of PRISMA literature review requirements’ criteria and PICO data selection method. The following keywords and their combinations were used: “acute”, “diverticulitis”, “guidelines”, “diverticulosis”, “diagnostics”, “treatment”. Results. 6/6 guidelines agree on ultrasound and 7/7 on computed tomography with contrast appropriateness in the acute diverticulitis diagnostics. 5/5 guidelines concurred that uncomplicated diverticulitis can be handled outpatient routinely and 7/8 that the usage of antibiotics in its handling is unjustifiable. 6/6 guidelines accord to the treatment of small abscesses with antibiotics, 7/7 to the treatment of large abscesses with antibiotics and drenage. 5/7 guidelines agree on Hinchey stage III acute diverticulitis treatment with primary resection anastomosis with or without diverting ileostomy. There is a discordance regarding the treatment approaches of the Hinchey stage IV acute diverticulitis. Conclusions. 1. Ultrasound and computed tomography with contrast are the first-line diagnostic modalities in acute diverticulitis (high level of evidence and recommendations). 2. Antibiotics are not routinely recommended for uncomplicated diverticulitis, drenage is appropriate for large abscesses, while antibiotics are acceptable both for small and large abscesses (high-low levels of evidence and recommendations). 3. The most appropriate treatment for Hinchey stage III acute diverticulitis is primary resection anastomosis with or without diverting ileostomy (moderate-low levels of evidence and recommendations). Key words. Acute diverticulitis, diagnosis, treatment, literature review. |
