EC Gastroenterology and Digestive System

Keywords: C-Reactive Protein; Acute Diverticulitis; Emergency Department; Hinchey Classification

Abbreviations

ED: Emergency Department; CRP: C-Reactive Protein; WBC: White Blood Cell Count; AD: Acute Diverticulitis; AUD: Acute Uncomplicated Diverticulitis; ACD: Acute Complicated Diverticulitis; CT: Computed Tomography

Acute diverticulitis both complicated and uncomplicated is an ever-increasing disease. The clinical management of acute uncomplicated diverticulitis has changed in the recent years, been considered as a self-limiting condition; so, the majority of patients can be followed in an output setting without antibiotics. The prescription of antibiotics is reserved for elderly immunocompromised patients with many comorbidities and presenting clinical and laboratory signs of systemic involvement. The most used serological markers of inflammation in ED are CRP and WBC.

1. Tursi A., et al. “Colonic diverticular disease”. Nature Reviews Disease Primers 03 26 6.1 (2020): 20.
2. Jain M and Dechet A. “In mild acute diverticulitis, outpatient therapy without antibiotics was noninferior to antibiotics”. Annals of Internal Medicine2 (2022): JC15.
3. Curran T and Kwaan MR. “Controversies in the Management of Diverticulitis”. Advances in Surgery 54 (2020): 1-16.
4. Choi J., et al. “Prospectively Assigned AAST Grade versus Modified Hinchey Class and Acute Diverticulitis Outcomes”. Journal of Surgical Research 259 (2021): 555-561.
5. Vermeire S., et al. “The role of C-reactive protein as an inflammatory marker in gastrointestinal diseases”. Nature Reviews Gastroenterology and Hepatology12 (2005): 580-586.
6. Covino M., et al. “Development and Validation of Predictive Assessment of Complicated Diverticulitis Score”. Journal of Personalized Medicine2 (2021): 80.
7. Aristotelis K., et al. “The Early C-reactive Protein Trend Does Not Have a Role in Monitoring Acute Diverticulitis Progression”. Chirurgia 111 (2016): 43-47.