Ann Coloproctol.  2023 Apr;39(2):123-130. 10.3393/ac.2021.00402.0057.

Right-sided acute diverticulitis in the West: experience at a university hospital in Argentina

• Huatuco RMP
• Pachajoa DAP
• Liaño JE
• Molina HAP
• Palencia R
• Doniquian AM
• Parodi M

• KMID: 2541830
• DOI: http://doi.org/10.3393/ac.2021.00402.0057

Abstract

Purpose
In the West, diverticular disease is located mainly in the left colon. However, it can also present in the right colon, with an incidence of 1%–2% in Caucasians. The purpose of this study was to describe our experience in right-sided acute diverticulitis (RD).
Methods
In this retrospective study, 410 patients with acute diverticulitis treated from 2013 to 2020 were included in a university hospital in Córdoba, Argentina. Colonic diverticulitis was stratified into 2 groups; RD and left-sided acute diverticulitis. Demographic and clinical variables, laboratory and imaging findings, type of treatment, follow-up, and recurrence were analyzed.
Results
Sixteen patients (3.9%) with RD were identified; 62.5% were male and the mean age was 40.7±11.7 years. A total of 81.3% were Caucasian and 18.7% Native American. Significant differences were found between both groups of diverticulitis; patients with RD were younger (P=0.001), with lower BMI (P=0.01), comorbidity rate (P=0.01), Charlson comorbidity index (P=0.02), hospital stay (P=0.01), severity according to the Hinchey classification (P=0.001) and had a lower recurrence rate (P=0.001). There were no significant differences in sex (P=0.95), duration of pain until admission (P=0.05), laboratory findings (P=0.23) and treatment (P=0.34).
Conclusion
Conservative treatment predominated in RD, with a lower rate of complications and recurrences, providing data that support conservative therapy as initial treatment in RD in our environment.

Keyword

Colonic diverticulitis; Hepatic flexure; Conservative treatment; South America; Neutrophil-to-lymphocyte ratio