Acute Uncomplicated Diverticulitis in Adults

Publication: 01/04/2009

Next review: 21/02/2025

Clinical Guideline

CURRENT

ID: 1413

Approved By: Improving Antimicrobial Prescribing Group

This Clinical Guideline is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

Guidelines for Investigation and Management of Acute Uncomplicated Diverticulitis in Adults

Diagnostics
Empirical Treatment

Uncomplicated diverticulitis can be defined as diverticulitis without abscess, fistula, bowel obstruction, or perforation.

DIAGNOSTICS

For patients with a presumed diagnosis of acute uncomplicated diverticulitis the following diagnostic tests should be taken to confirm diagnosis:

All patients

FBC
U&Es

Selected patients

For patients with suspected complicated diverticulitis:

Blood cultures
CT Abdomen with intravenous contrast is likely to be indicated.

Abdominal X-ray (supine) may be indicated

EMPIRICAL TREATMENT

Recommended treatment

Uncomplicated diverticulitis

Antibiotics are not normally indicated
If a patient has clinical evidence of systemic sepsis i.e., there is doubt over the diagnosis, please prescribe antibiotics as per complicated diverticulitis.

Complicated diverticulitis

Defined as diverticulitis accompanied by abscess, fistula, bowel obstruction, or perforation.

See: Infection related management of complicated intra-abdominal infection (excluding appendicitis) guideline
Empirical antibiotics for suspected complicated diverticulitis should normally be stopped if radiologically reported as uncomplicated diverticulitis.

Provenance

Record:	1413
Objective:
Clinical condition:	Acute Diverticulitis
Target patient group:	Adults
Target professional group(s):	Secondary Care Doctors Pharmacists
Adapted from:

Evidence base

Chabok A, Påhlman L, Hjern F, Haapaniemi S, Smedh K; AVOD Study Group. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012 Apr;99(4):532-9. doi: 10.1002/bjs.8688. Epub 2012 Jan 30. PMID: 22290281.
Sartelli, M., Weber, D.G., Kluger, Y. et al. 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting. World J Emerg Surg 15, 32 (2020). https://doi.org/10.1186/s13017-020-00313-4.

Approved By

Improving Antimicrobial Prescribing Group

Document history

LHP version 2.0

Related information

Not supplied

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