Effectiveness of conservative approach in right colon diverticulitis

BACKGROUND: Approximately 10%–25% of patients with colon diverticular disease experience colonic diverticulitis during their lives. Right-sided diverticulosis is a rare condition in Western countries, but it is common among Asian countries. The aim of this study was to evaluate the clinical and treatment outcomes in our patients with right colon diverticulitis.
METHODS: Demographic and clinical data of 22 patients with a diagnosis of cecum and right-sided colon diverticulitis between 2014 and 2017 were analyzed. The Hinchey staging was applied according to the radiological evaluation and clinical findings. Then, the proportions of demographic and clinical features of the patients according to the Hinchey staging and its statistical significance were evaluated.
RESULTS: Our study included 22 patients who suffered from right colon diverticulitis. The female-to-male ratio was 0.69. A total of 68.1% of the patients were the Hinchey Stage I, and 31.8% were the Hinchey Stage II, all of which were evaluated by tomography. The Hinchey Stage I diverticulitis was mostly found in the right colon (66.7%) and the Hinchey Stage II diverticulitis in the cecum (57.1%). The mean age of the Hinchey Stage II patients was higher (63.6 years) and statistically significant (p<0.05). Two patients had appendectomy, and one had right hemicolectomy. Conservative treatment was applied to other 19 patients. The mean hospitalization time was 3.4 days. Four patients who received conservative treatment at the 2-year follow-up had recurrence. No recurrence was observed in patients receiving surgical treatment.
CONCLUSION: Right colon diverticulitis is usually seen in solitary men aged <50 years from Eastern societies. As a treatment option, conservative methods should be preferred, especially in uncomplicated cases. Surgical treatment is usually used in the treatment of recurrent and complicated cases.

Sað kolon divertikülitinde konservatif yaklaþýmýn etkinliði

AMAÇ: Kolon divertikül hastalarýnýn yaklaþýk %10–25’i hayatlarý boyunca kolon divertiküliti ile karþýlaþmaktadýrlar. Batý ülkelerinde sað taraflý divertiküler hastalýk nadir görülen bir durum iken, Asya ülkeleri arasýnda yaygýndýr. Bu çalýþmanýn amacý, sað kolon divertiküliti saptanýlan hastalarýmýzýn klinik ve tedavi sonuçlarýný deðerlendirmektir.
GEREÇ VE YÖNTEM: 2011 ve 2015 yýllarý arasýnda çekum ve sað kolon divertiküliti tanýsýyla tedavi edilen 22 hastanýn demografik ve klinik verileri analiz edildi. Radyolojik inceleme ve klinik bulgulara göre hastalara Hinchey Evrelemesi yapýldý. Daha sonra Hinchey Evrelemesine göre hastalarýn demografik ve klinik özelliklerinin oransal olarak deðerlerine ve istatistiksel olarak olarak anlamlýlýðýna bakýldý.
BULGULAR: Araþtýrmamýza sað kolon divertiküliti tanýsý konulan 22 hasta alýndý. Kadýn/erkek oraný 0.69 idi. Karýn tomografisi ile yapýlan deðerlendirme sonrasýnda hastalarýn %68.1’i Hinckey evre I, %31.8’i Hinckey evre II divertikülit saptandý. Çoðunlukla Hinchey Evre I divertikülit sað kolonda (%66.7) ve Hinchey Evre II divertikülit çekumda (%57.1) bulundu. Hinchey Evre II hastalarýnýn ortalama yaþý daha yüksekti (ortalama, 63.6 yýl) ve istatistiksel olarak anlamlýydý (p<0.05). Ýki hastada apendektomi ve bir hastada sað hemikolektomi yapýlmýþtý. Diðer 19 hastaya konservatif tedavi uygulandý. Ortalama hastanede yatýþ süresi 3.4 gündü. Ýki yýllýk takipte konservatif tedavi alan dört hastada nüks görüldü; cerrahi tedavi alan hastalarda nüks görülmedi.
TARTIÞMA: Sað kolon divertiküliti genellikle doðu toplumlarýnda 50 yaþ altý erkeklerde ve soliter olarak görülmektedir. Tedavi seçeneði olarak özellikle komplike olmayan olgularda konservatif yöntemler tercih edilmelidir. Cerrahi tedavi ise genellikle nüks ve komplike olgularýn tedavisinde kullanýlmalýdýr.