Radyolojik ve klinik bulgulara raðmen sað kolon divertiküllerinin tanýsýnda cerrahi gerekli mi?

AMAÇ: Batý toplumlarýnda sað kolon divertikülleri nadir görülmektedir. Bu çalýþmanýn amacý bilgisayarlý tomografi ile tanýsý konan sað kolon divertiküllerinin konservatif tedavi ile sonuçlarýný deðerlendirmektir.
GEREÇ VE YÖNTEM: Þubat 2013 ile Aralýk 2013 tarihleri arasýnda klinik ve radyolojik olarak sað kolon ve çekal divertikülleri olan ve konservatif olarak tedavi edilen 12 hasta çalýþmaya alýndý. Demografik ve klinik veriler geriye dönük olarak deðerlendirildi.
BULGULAR: Çalýþmaya katýlan kadýn ve erkeklerin sayýsý birbirine eþitti. Ortalama yaþ 45.08±14.4 yýl idi. Hastalarýn hastaneye baþvurmadan önce geçen süre 2.08±1.3 gün olup, en sýk görülen semptom sað alt kadran aðrýsýydý (%72.7). On hastaya sadece abdominal tomografi çekilirken, iki hastaya hem abdominal tomografi hem de abdominal ultrasonografi çekilmiþti. Ortalama hastanede yatýþ süresi 2.8±1.5 gün olup hastalarýn hepsi konservatif olarak tedavi edildi. Ortalama 8.2±5.6 aylýk takipte hiçbir hastada nüks gözlenmedi.
TARTIÞMA: Komplike olmayan sað kolon divertikülleri radyolojik olarak tanýmlanabilir, baðýrsaklarýn istirahati ile birlikte antibiyotik tedavisi düþük nüks olanlarý ile tedavi seçeneði olarak kullanýlabileceði gibi sonraki dönemlerde cerrahi gerekebileceði akýlda tutulmalýdýr.

Is surgery necessary to confirm diagnosis of right-sided diverticulitis in spite of relevant clinical and radiological findings?

BACKGROUND: Diverticulosis of the right colon is an uncommon entity. Aim of the present study was to report outcome in patients with right-sided diverticulitis diagnosed using computed tomography (CT) and treated conservatively.
METHODS: Twelve patients with clinical and radiological diagnosis of cecal or right-sided diverticulitis who were treated conservatively between February 2013 and December 2014 were included. Demographic and clinical data were retrospectively analyzed.
RESULTS: Female to male ratio was 1: 1 with mean age of 45.08±14.4 years. Mean length of symptom history before admission was 2.08±1.3 days. Most common presenting symptom was right lower abdominal pain, seen in 72.7% of the patients. Abdominal ultrasound alone was performed for 10 patients, and 2 also had abdominal CT. Mean duration of hospitalization was 2.8±1.5 days. All patients were successfully treated with medical therapy. There was no recurrence during mean follow-up period of 8.2±5.6 months.
CONCLUSION: If uncomplicated diverticulitis of the right colon is correctly diagnosed with radiological evaluation, antibiotic therapy and bowel rest should be considered as treatment modality, as there was no recurrence observed in short-term follow-up period and this option presents advantage of avoiding surgical intervention.