Primary diverticulitis with abscess formation and young age increased the risk of recurrence .
Readmission risk was higher within the first year after remission .
Conclusions The best treatment strategy for recurrent diverticulitis is undetermined .
Purpose Several factors may influence the risk of recurrence after an episode of acute colonic diverticulitis .
Until now , a comprehensive systematic overview and evaluation of relevant risk factors have not been presented .
This review aim ed at assembling and evaluating current evidence on risk factors for recurrence after conservatively treated acute colonic diverticulitis .
Long-Term Evolution of Acute Colonic Diverticulitis After Successful Medical Treatment
Background The evidence is sparse concerning the natural history of acute diverticulitis after successful conservative management . This observational study aim ed to evaluate the rate , severity , and need of surgery for recurrence after a first episode of acute diverticulitis successfully managed conservatively . Methods All patients admitted for acute diverticulitis between 1994 and 2011 were considered for inclusion in the study . Severity of the first episode , demographic data , comorbidities , management , recurrence , and elective or emergency surgery during the follow-up period were prospect ively recorded . Results The study included 560 patients . The mean follow-up period was of 67.2 ± 44.4 months . Severe diverticulitis was diagnosed in 22.3 % of the cases . Recurrence was observed in 14.8 % of the patients , and the rate of severe recurrence was 3.4 % . Most of the recurrences occurred during the first year of follow-up evaluation . Chronic corticoid therapy ( P = 0.043 ) and the presence of more than one abscess ( P < 0.001 ) were significantly related to recurrence . In the event of a mild recurrence , the first episode was either mild or severe ( P = 0.172 ) . In the case of severe recurrence , most patients presented with a previous severe diverticulitis ( P < 0.001 ) . During the follow-up period , 6.8 % of the patients needed an elective operation , and 1.4 % of them underwent emergency surgery . Conclusion The rate of severe recurrence after successful nonoperative management of acute diverticulitis was low , and emergency surgery was rare . Prophylactic surgery , even in cases of recovered severe diverticulitis , should be considered on a case-by-case basis . Strict follow-up assessment during the first year is advised
Primary diverticulitis with abscess formation and young age increased the risk of recurrence .
Readmission risk was higher within the first year after remission .
Conclusions The best treatment strategy for recurrent diverticulitis is undetermined .
Purpose Several factors may influence the risk of recurrence after an episode of acute colonic diverticulitis .
Until now , a comprehensive systematic overview and evaluation of relevant risk factors have not been presented .
This review aim ed at assembling and evaluating current evidence on risk factors for recurrence after conservatively treated acute colonic diverticulitis .