How Would You Manage This Patient With Recurrent Diverticulitis?
Authors: Takeshi Fujieda, Tetsuya Tanimoto
Journal: Annals of Internal Medicine (2024)

LettersJanuary 2024How Would You Manage This Patient With Recurrent Diverticulitis?Takeshi Fujieda, MD, and Tetsuya Tanimoto, MDTakeshi Fujieda, MDKitaibaraki City Hospital, Kitaibaraki, JapanSearch for more papers by this author, and Tetsuya Tanimoto, MDKitaibaraki City Hospital and Navitas Clinic Kawasaki, Kitaibaraki and Minato-ku, JapanSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L23-0415 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: We read with interest Libman and colleagues' article (1), which discusses the use of computed tomography (CT) scanning, antibiotics, colonoscopy, and elective surgery in diagnosing and treating acute diverticulitis. The authors' findings are important and in line with previous reports; the American College of Physicians recommends using abdominal CT imaging in cases of diagnostic uncertainty for patients with suspected acute left-sided colonic diverticulitis (conditional recommendation; low-certainty evidence) (2). Computed tomography is a widely used imaging study to diagnose diverticulitis, and most classifications are based on CT findings (3). However, we would like to scrutinize a crucial point ...References1. Libman H, Nee JW, Lembo AJ, et al. How would you manage this patient with recurrent diverticulitis? Grand rounds discussion from Beth Israel Deaconess Medical Center. Ann Intern Med. 2023;176:836-843. [PMID: 37307586] doi:10.7326/M23-0669 LinkGoogle Scholar2. Qaseem A, Etxeandia-Ikobaltzeta I, Lin JS, et al; Clinical Guidelines Committee of the American College of Physicians. Diagnosis and management of acute left-sided colonic diverticulitis: a clinical guideline from the American College of Physicians. Ann Intern Med. 2022;175:399-415. [PMID: 35038273] doi:10.7326/M21-2710 LinkGoogle Scholar3. Ambrosetti P, Becker C, Terrier F. Colonic diverticulitis: impact of imaging on surgical management—a prospective study of 542 patients. Eur Radiol. 2002;12:1145-1149. [PMID: 11976860] CrossrefMedlineGoogle Scholar4. Dirks K, Calabrese E, Dietrich CF, et al. EFSUMB position paper: recommendations for gastrointestinal ultrasound (GIUS) in acute appendicitis and diverticulitis. Ultraschall Med. 2019;40:163-175. [PMID: 30616263] doi:10.1055/a-0824-6952 CrossrefMedlineGoogle Scholar5. Laméris W, van Randen A, Bipat S, et al. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol. 2008;18:2498-2511. [PMID: 18523784] doi:10.1007/s00330-008-1018-6 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Takeshi Fujieda, MD; Tetsuya Tanimoto, MDAffiliations: Kitaibaraki City Hospital, Kitaibaraki, JapanKitaibaraki City Hospital and Navitas Clinic Kawasaki, Kitaibaraki and Minato-ku, JapanDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L23-0415. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHow Would You Manage This Patient With Recurrent Diverticulitis? Howard Libman , Judy W. Nee , Anthony J. Lembo , and Risa B. Burns How Would You Manage This Patient With Recurrent Diverticulitis? Judy W. Nee , Anthony J. Lembo Metrics Current Issue January 2024Volume 177, Issue 1 Keywords Abdominal pain Antibiotics Colonoscopy Colorectal cancer Computed axial tomography Diverticulitis Randomized trials Surgery ePublished: 16 January 2024 Issue Published: January 2024 Copyright & PermissionsCopyright © 2024 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...