Diverticulitis : Diagnosis and therapy [Divertikulitis : Diagnose und Therapie]

The frequency of diverticular disease is increasing in Western countries because of a lack of dietary fibre, and the prevalence increases with age. Diverticulitis is a complication of diverticular disease. It affects 10-20% of patients suffering from diverticulosis, involving the left colon only in 90% of all cases. The main symptoms are abdominal pain and increased markers of systemic infection. In acute diverticulitis, the diagnosis is made by imaging studies, and endoscopic confirmation is done as a follow-up examination. The cornerstones of therapy are bowel rest, antibiotic therapy, and percutaneous drainage of abscesses. Surgery remains limited to peritonitis and should be done as an elective procedure after the acute inflammation has resolved. The recommendation for elective surgery after the second event of acute diverticulitis is upheld despite low evidence for this procedure. © 2009 Springer Medizin Verlag.