The outcomes of right and left complicated colonic diverticulitis

Background

The incidence of complicated colonic diverticulitis is increasing in Asia, with notable differences in management between right-sided (RCD) and left-sided (LCD) cases. This study compared treatment outcomes and identified risk factors for complications.

Methods

A retrospective analysis was performed on 181 patients diagnosed with complicated colonic diverculitis from January 2022 to September 2024, including 99 RCD and 82 LCD cases.

Results

The mean age in the RCD group was 43.31 ± 14.6 years, compared to 63.9 ± 12.9 years in the LCD group. Recurrence rates were higher in LCD than RCD (19.5 % vs. 7.1 %). Surgical intervention was more frequent in LCD cases (63.4 % vs. 9.2 %), with longer hospital stay (9.3 vs 4.9 days). All RCD perforations were managed with primary anastomosis. Hartmann's procedure was the most common approach for LCD, with primary resection and anastomosis performed in 26.9 %. Postoperative complications occurred in 27.8 % of LCD patients, including wound infections, intra-abdominal abscesses, and pneumonia. Three patients in the LCD group died during hospitalization. Fever, elevated CRP levels, surgery type, and prolonged hospital stays were independent risk factors.

Conclusion

Patients with complicated RCD were younger than those with LCD. Conservative treatment for RCD had a high success rate, while complicated LCD often required surgery due to peritonitis. Fever, CRP level, type of surgery, and hospital stay were independent risk factors for complications.