Issues of diagnosis and treatment of acute diverticulitis of the colon (review)
https://doi.org/10.33878/2073-7556-2025-24-4-201-208
Abstract
The literature review highlights modern approaches to the diagnosis and choice of treatment for acute diverticulitis of the colon. The significance and effectiveness of clinical laboratory and imaging research methods are considered. Ultrasound and computed tomography are currently the most accurate diagnostic methods for acute diverticulitis, with a sensitivity of 85–97% and a specificity of 90–99%. Special attention is paid to surgical tactics in complicated diverticulitis, the role and place of percutaneous interventions, various options for colon resection, including laparoscopic access.
Keywords
acute diverticulitis,
complicated diverticulitis,
diagnosis,
conservative treatment,
minimally invasive methods,
surgical interventions
Supporting agencies: there are no sources of financing
About the Authors
Sh. V. Timerbulatov
Bashkir State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Shamil V. Timerbulatov
Lenin st., 3, Ufa, 450008
A. R. Gafarova
Bashkir State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Aigul R. Gafarova
Lenin st., 3, Ufa, 450008
V. M. imerbulatov
Bashkir State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Vil M. Timerbulatov
Lenin st., 3, Ufa, 450008
References
1. Weizman A.V., Nguyen G.C. Diverticular disease: epidemiology and management // Can J Gastroenterol. 2011. Vol. 25. P. 385-389. DOI: 10.1155/2011/795241.
2. Schoetz D.J. Diverticular disease of the colon: a century-old problem // Dis Colon Rectum. 1999. Vol. 42, № 6. P. 703-709. DOI: 10.1007/BF02236925.
3. Shahedi K., Fuller G., Bolus R. et al. Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy // Clin Gastroenterol Hepatol. 2013. Vol. 11, № 12. P. 1609-1613. DOI: 10.1016/j.cgh.2013.06.020.
4. Collins D., Winter D.C. Modern concepts in diverticular disease // J Clin Gastroenterol. 2015. Vol. 49, № 5. P. 358-369. DOI: 10.1097/MCG.0000000000000297.
5. Warner E., Crighton E.J., Moineddin R. et al. Fourteen-year study of hospital admissions for diverticular disease in Ontario // Can J Gastroenterol Hepatol. 2016. Vol. 2016. Article ID 3562639. DOI: 10.1155/2016/3562639.
6. Kang J.Y., Hoare J., Tinto A. et al. Diverticular disease of the colon - on the rise: a study of hospital admissions in England between 1989/1990 and 1999/2000 // Aliment Pharmacol Ther. 2003. Vol. 17, № 9. P. 1189-1195. DOI: 10.1046/j.1365-2036.2003.01570.x.
7. Etzioni D.A., Mack T.M., Beart R.W. et al. Diverticulitis in the United States: 1998-2005: changing patterns of disease and treatment // Ann Surg. 2009. Vol. 249, № 2. P. 210-217. DOI: 10.1097/SLA.0b013e3181952888.
8. Theodoropoulos D. Current options for the emergency management of diverticular disease and options to reduce the need for colostomy // Clin Colon Rectal Surg. 2018. Vol. 31, № 4. P. 229-235. DOI: 10.1055/s-0037-1607965.
9. Hupfeld L., Burcharth J., Pommergaard H.C. et al. Risk factors for recurrence after acute colonic diverticulitis: a systematic review // Int J Colorectal Dis. 2017. Vol. 32, № 5. P. 611-622. DOI: 10.1007/s00384-017-2762-3.
10. Ho V.P., Nash G.M., Milsom J.W. et al. Identification of diverticulitis patients at high risk for recurrence and poor outcomes // J Trauma Acute Care Surg. 2015. Vol. 78, № 1. P. 112-119. DOI: 10.1097/TA.0000000000000489.
11. Hajibandeh S., Hajibandeh S., Smart N.J. et al. Meta-analysis of the demographic and prognostic significance of right-sided versus left-sided acute diverticulitis // Colorectal Dis. 2020. Vol. 22, № 12. P. 1908-1923. DOI: 10.1111/codi.15226.
12. Guyatt G.H., Oxman A.D., Vist G.E. et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations // BMJ. 2008. Vol. 336, № 7650. P. 924-926. DOI: 10.1136/bmj.39489.470347.AD.
13. Brozek J.L., Akl E.A., Jaeschke R. et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines: part 2 of 3. The GRADE approach to grading quality of evidence about diagnostic tests and strategies // Allergy. 2009. Vol. 64, № 8. P. 1109-1116. DOI: 10.1111/j.1398-9995.2009.02083.x.
14. Hinchey E.J., Schaal P.H., Richards G.K. Treatment of perforated diverticular disease of the colon // Adv Surg. 1978. Vol. 12. P. 85-109. PMID: 735943.
15. Mora Lopez L., Serra Pla S., Serra-Aracil X. et al. Application of a modified Neff classification to patients with uncomplicated diverticulitis // Colorectal Dis. 2013. Vol. 15, № 12. P. 1442-1447. DOI: 10.1111/codi.12375.
16. Sallinen V.J., Leppäniemi A.K., Mentula P.J. Staging of acute diverticulitis based on clinical, radiologic, and physiologic parameters // J Trauma Acute Care Surg. 2015. Vol. 78, № 3. P. 543-551. DOI: 10.1097/TA.0000000000000549.
17. Шелыгин Ю.А., Ивашкин В.Т., Ачкасов С.И. и др. Клинические рекомендации "Дивертикулярная болезнь (К57.2, К57.3), взрослые" // Колопроктология. 2024. Т. 23, № 2. С. 10-27. DOI: 10.33878/2073-7556-2024-23-2-10-27.
18. Huang S.S., Sung C.W., Wang H.P. et al. The outcomes of right-sided and left-sided colonic diverticulitis following non-operative management: a systematic review and meta-analysis // World J Emerg Surg. 2022. Vol. 17, № 1. Art. 56. DOI: 10.1186/s13017-022-00463-7.
19. Park S.M., Kwon T.S., Kim D.J. et al. Prediction and management of recurrent right colon diverticulitis // Int J Colorectal Dis. 2014. Vol. 29, № 11. P. 1355-1360. DOI: 10.1007/s00384-014-2000-1.
20. Park Y.Y., Nam S., Han J.H. et al. Predictive factors for conservative treatment failure of right colonic diverticulitis // Ann Surg Treat Res. 2021. Vol. 100, № 6. P. 347-355. DOI: 10.4174/astr.2021.100.6.347.
21. Park J.H., Park H.C., Lee B.H. One-day versus four-day antibiotic treatment for acute right colonic uncomplicated diverticulitis: a randomized clinical trial // Turk J Gastroenterol. 2019. Vol. 30, № 7. P. 605-610. DOI: 10.5152/tjg.2019.18423.
22. Mueller M.H., Glatzle J., Kasparek M.S. et al. Long-term outcome of conservative treatment in patients with diverticulitis of the sigmoid colon // Eur J Gastroenterol Hepatol. 2005. Vol. 17, № 6. P. 649-654. DOI: 10.1097/00042737-200506000-00010.
23. Frileux P., Dubrez J., Burdy G. et al. Sigmoid diverticulitis. Longitudinal analysis of 222 patients with a minimal follow up of 5 years // Colorectal Dis. 2010. Vol. 12, № 7. P. 674-680. DOI: 10.1111/j.1463-1318.2009.01896.x.
24. Daniels L., Ünlü Ç., de Korte N. et al. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis // Br J Surg. 2017. Vol. 104, № 1. P. 52-61. DOI: 10.1002/bjs.10309.
25. Pisanu A., Vacca V., Reccia I. et al. Acute diverticulitis in the young: the same disease in a different patient // Gastroenterol Res Pract. 2013. Vol. 2013. Article ID 867961. DOI: 10.1155/2013/867961.
26. Brochmann N.D., Schultz J.K., Jakobsen G.S. et al. Management of acute uncomplicated diverticulitis without antibiotics: a single-centre cohort study // Colorectal Dis. 2016. Vol. 18, № 11. P. 1101-1107. DOI: 10.1111/codi.13313.
27. Toorenvliet B.R., Bakker R.F., Breslau P.J. et al. Colonic diverticulitis: a prospective analysis of diagnostic accuracy and clinical decision-making // Colorectal Dis. 2010. Vol. 12, № 3. P. 179-186. DOI: 10.1111/j.1463-1318.2009.01807.x.
28. Kechagias A., Rautio T., Kechagias G. et al. The role of C-reactive protein in the prediction of the clinical severity of acute diverticulitis // Am Surg. 2014. Vol. 80, № 4. P. 391-395. PMID: 24887671.
29. Mäkelä J.T., Klintrup K., Takala H. et al. The role of C-reactive protein in prediction of the severity of acute diverticulitis in an emergency unit // Scand J Gastroenterol. 2015. Vol. 50, № 5. P. 536-541. DOI: 10.3109/00365521.2014.1003398.
30. Kechagias A., Sofianidis A., Zografos G. et al. Index C-reactive protein predicts increased severity in acute sigmoid diverticulitis // Ther Clin Risk Manag. 2018. Vol. 14. P. 1847-1853. DOI: 10.2147/TCRM.S172083.
31. Gewurz H., Mold C., Siegel J. et al. C-reactive protein and the acute phase response // Adv Intern Med. 1982. Vol. 27. P. 345-372. PMID: 7041546.
32. Andeweg C.S., Wegdam J.A., Groenewoud J. et al. Toward an evidence-based step-up approach in diagnosing diverticulitis // Scand J Gastroenterol. 2014. Vol. 49, № 7. P. 775-784. DOI: 10.3109/00365521.2014.908475.
33. Laméris W., van Randen A., Bipat S. et al. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy // Eur Radiol. 2008. Vol. 18, № 11. P. 2498-2511. DOI: 10.1007/s00330-008-1018-6.
34. Mazzei M.A., Cioffi Squitieri N., Guerrini S. et al. Sigmoid diverticulitis: US findings // Crit Ultrasound J. 2013. Vol. 5, Suppl 1. P. S1-S5. DOI: 10.1186/2036-7902-5-S1-S1.
35. Puylaert J.B. Ultrasound of colon diverticulitis // Dig Dis. 2012. Vol. 30, № 1. P. 56-59. DOI: 10.1159/000336620.
36. Andeweg C.S., Wegdam J.A., Groenewoud J. et al. Toward an evidence-based step-up approach in diagnosing diverticulitis // Scand J Gastroenterol. 2014. Vol. 49, № 7. P. 775-784. DOI: 10.3109/00365521.2014.908475.
37. Laméris W., van Randen A., van Es H.W. et al. OPTIMA study group: imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study // BMJ. 2009. Vol. 338. Art. b2431. DOI: 10.1136/bmj.b2431.
38. Halpenny D.F., McNeil G., Snow A. et al. Prospective evaluation of the value of magnetic resonance imaging in suspected acute sigmoid diverticulitis // Dis Colon Rectum. 2009. Vol. 52, № 5. P. 1030-1031. DOI: 10.1007/DCR.0b013e31819f5c7b.
39. Peery A.F., Shaukat A., Strate L.L. AGA clinical practice update on medical management of colonic diverticulitis: expert review // Gastroenterology. 2021. Vol. 160, № 3. P. 906-911. DOI: 10.1053/j.gastro.2020.09.059.
40. Schultz J.K., Azhar N., Binda G.A. et al. European Society of Coloproctology: guidelines for the management of diverticular disease of the colon // Colorectal Dis. 2020. Vol. 22, Suppl 2. P. 5-28. DOI: 10.1111/codi.15140.
41. Hall J., Hardiman K., Lee S. et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the treatment of left-sided colonic diverticulitis // Dis Colon Rectum. 2020. Vol. 63, № 6. P. 728-747. DOI: 10.1097/DCR.0000000000001679.
42. Balk E.M., Adam G.P., Bhuma M.R. et al. Diagnostic imaging and medical management of acute left-sided colonic diverticulitis: a systematic review // Ann Intern Med. 2022. Vol. 175, № 3. P. 379-387. DOI: 10.7326/M21-1645.
43. Kruis W., Germer C.T., Böhm S. et al. German guideline diverticular disease/diverticulitis: Part II: conservative, interventional and surgical management // United European Gastroenterol J. 2022. Vol. 10, № 9. P. 940-957. DOI: 10.1002/ueg2.12308.
44. Rajpurkar P., Lungren M.P. The current and future state of AI interpretation of medical images // N Engl J Med. 2023. Vol. 388, № 21. P. 1981-1990. DOI: 10.1056/NEJMra2206733.
45. Daniels L., Ünlü Ç., de Korte N. et al. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis // Br J Surg. 2017. Vol. 104, № 1. P. 52-61. DOI: 10.1002/bjs.10309.
46. Sarin S., Boulos P.B. Long-term outcome of patients presenting with acute complications of diverticular disease // Ann R Coll Surg Engl. 1994. Vol. 76, № 2. P. 117-120. PMID: 8154816.
47. Hjern F., Josephson T., Altman D. et al. Conservative treatment of acute colonic diverticulitis: are antibiotics always mandatory? // Scand J Gastroenterol. 2007. Vol. 42, № 1. P. 41-47. DOI: 10.1080/00365520600825257.
48. Peery A.F. It's actually a little complicated: antibiotics for uncomplicated diverticulitis // Am J Gastroenterol. 2018. Vol. 113, № 7. P. 949-950. DOI: 10.1038/s41395-018-0101-0.
49. Mege D., Yeo H. Meta-analyses of current strategies to treat uncomplicated diverticulitis // Dis Colon Rectum. 2019. Vol. 62, № 3. P. 371-378. DOI: 10.1097/DCR.0000000000001323.
50. Biondo S., Golda T., Kreisler E. et al. Outpatient versus hospitalization management for uncomplicated diverticulitis: a prospective, multicenter randomized clinical trial (DIVER Trial) // Ann Surg. 2014. Vol. 259, № 1. P. 38-44. DOI: 10.1097/SLA.0b013e3182965a11.
51. Bolkenstein H.E., Draaisma W.A., van de Wall B. et al. Treatment of acute uncomplicated diverticulitis without antibiotics: risk factors for treatment failure // Int J Colorectal Dis. 2018. Vol. 33, № 7. P. 863-869. DOI: 10.1007/s00384-018-3055-1.
52. Ünlü Ç., Gunadi P.M., Gerhards M.F. et al. Outpatient treatment for acute uncomplicated diverticulitis // Eur J Gastroenterol Hepatol. 2013. Vol. 25, № 9. P. 1038-1043. DOI: 10.1097/MEG.0b013e328361dd5b.
53. Moya P., Arroyo A., Pérez-Legaz J. et al. Applicability, safety and efficiency of outpatient treatment in uncomplicated diverticulitis // Tech Coloproctol. 2012. Vol. 16, № 4. P. 301-307. DOI: 10.1007/s10151-012-0847-0.
54. Joliat G.R., Emery J., Demartines N. et al. Antibiotic treatment for uncomplicated and mild complicated diverticulitis: outpatient treatment for everyone // Int J Colorectal Dis. 2017. Vol. 32, № 9. P. 1313-1319. DOI: 10.1007/s00384-017-2847-z.
55. Balk E.M., Adam G.P., Bhuma M.R. et al. Diagnostic imaging and medical management of acute left-sided colonic diverticulitis: a systematic review // Ann Intern Med. 2022. Vol. 175, № 3. P. 379-387. DOI: 10.7326/M21-1645.
56. Andersen J.C., Bundgaard L., Elbrønd H. et al. Danish national guidelines for treatment of diverticular disease // Dan Med J. 2012. Vol. 59, № 5. Art. C4453. PMID: 22549495.
57. Gregersen R., Mortensen L.Q., Burcharth J. et al. Treatment of patients with acute colonic diverticulitis complicated by abscess formation: a systematic review // Int J Surg. 2016 Vol. 35 P. 201-208. DOI: 10.1016/j.ijsu.2016.09.080.
58. Sartelli M., Weber D.G., Kluger Y. et al. 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting // World J Emerg Surg. 2020 Vol. 15, № 1 Art. 32 DOI: 10.1186/s13017-020-00313-4.
59. Singh B., May K., Coltart I. et al. The long-term results of percutaneous drainage of diverticular abscess // Ann R Coll Surg Engl. 2008. Vol. 90, № 4. P. 297-301. DOI: 10.1308/003588408X285928.
60. Kumar R.R., Kim J.T., Haukoos J.S. et al. Factors affecting the successful management of intra-abdominal abscesses with antibiotics and the need for percutaneous drainage // Dis Colon Rectum. 2006. Vol. 49, № 2. P. 183-189. DOI: 10.1007/s10350-005-0274-7.
61. Elagili F., Stocchi L., Ozuner G. et al. Antibiotics alone instead of percutaneous drainage as initial treatment of large diverticular abscess // Tech Coloproctol. 2015. Vol. 19, № 2. P. 97-103. DOI: 10.1007/s10151-014-1253-6.
62. Yeo E.S., Ng K.H., Eu K.W. Perforated colorectal cancer: an important differential diagnosis in all presumed diverticular abscesses // Ann Acad Med Singap. 2011. Vol. 40, № 8. P. 375-378. PMID: 21939155.
63. de Vries H.S., Boerma D., Timmer R. et al. Routine colonoscopy is not required in uncomplicated diverticulitis: a systematic review // Surg Endosc. 2014. Vol. 28, № 7. P. 2039-2047. DOI: 10.1007/s00464-014-3436-7.
64. Rossi G.L., Mentz R., Bertone S. et al. Laparoscopic peritoneal lavage for Hinchey III diverticulitis: is it as effective as it is applicable? // Dis Colon Rectum. 2014. Vol. 57, № 12. P. 1384-1390. DOI: 10.1097/DCR.0000000000000243.
65. Swank H.A., Mulder I.M., Hoofwijk A.G. et al. Early experience with laparoscopic lavage for perforated diverticulitis // Br J Surg. 2013. Vol. 100, № 5. P. 704-710. DOI: 10.1002/bjs.9063.
66. Angenete E., Thornell A., Burcharth J. et al. Laparoscopic lavage is feasible and safe for the treatment of perforated diverticulitis with purulent peritonitis: the first results from the randomized controlled trial DILALA // Ann Surg. 2016. Vol. 263, № 1. P. 117-122. DOI: 10.1097/SLA.0000000000001061.
67. Schultz J.K., Yaqub S., Wallon C. et al. Laparoscopic lavage vs primary resection for acute perforated diverticulitis: the SCANDIV randomized clinical trial // JAMA. 2015. Vol. 314, № 13. P. 1364-1375. DOI: 10.1001/jama.2015.12076.
68. Vennix S., Musters G.D., Mulder I.M. et al. Laparoscopic peritoneal lavage or sigmoidectomy for perforated diverticulitis with purulent peritonitis: a multicentre, parallel-group, randomised, open-label trial // Lancet. 2015. Vol. 386, № 10000. P. 1269-1277. DOI: 10.1016/S0140-6736(15)61168-0.
69. Penna M., Markar S.R., Mackenzie H. et al. Laparoscopic lavage versus primary resection for acute perforated diverticulitis: review and meta-analysis // Ann Surg. 2018. Vol. 267, № 2. P. 252-258. DOI: 10.1097/SLA.0000000000002235.
70. Galbraith N., Carter J.V., Netz U. et al. Laparoscopic lavage in the management of perforated diverticulitis: a contemporary meta-analysis // J Gastrointest Surg. 2017. Vol. 21, № 9. P. 1491-1499. DOI: 10.1007/s11605-017-3485-z.
71. Hong M.K., Tomlin A.M., Hayes I.P. et al. Operative intervention rates for acute diverticulitis: a multicentre state-wide study // ANZ J Surg. 2015. Vol. 85, № 10. P. 734-738. DOI: 10.1111/ans.12868.
72. Li D., Baxter N.N., McLeod R.S. et al. Evolving practice patterns in the management of acute colonic diverticulitis: a population-based analysis // Dis Colon Rectum. 2014. Vol. 57, № 12. P. 1397-1405. DOI: 10.1097/DCR.0000000000000230.
73. Chandra V., Nelson H., Larson D.R. et al. Impact of primary resection on the outcome of patients with perforated diverticulitis // Arch Surg. 2004. Vol. 139, № 11. P. 1221-1224. DOI: 10.1001/archsurg.139.11.1221.
74. Cirocchi R., Trastulli S., Desiderio J. et al. Treatment of Hinchey stage III-IV diverticulitis: a systematic review and meta-analysis // Int J Colorectal Dis. 2013. Vol. 28, № 4. P. 447-457. DOI: 10.1007/s00384-012-1622-4.
75. Lee J.M., Bai P., Chang J. et al. Hartmann's procedure vs primary anastomosis with diverting loop ileostomy for acute diverticulitis: nationwide analysis of 2,729 emergency surgery patients // J Am Coll Surg. 2019. Vol. 229, № 1. P. 48-55. DOI: 10.1016/j.jamcollsurg.2019.03.007.
76. Constantinides V.A., Heriot A., Remzi F. et al. Operative strategies for diverticular peritonitis: a decision analysis between primary resection and anastomosis versus Hartmann's procedures // Ann Surg. 2007. Vol. 245, № 1. P. 94-103. DOI: 10.1097/01.sla.0000231758.07868.71.
77. Lambrichts D.P.V., Vennix S., Musters G.D. et al. Hartmann's procedure versus sigmoidectomy with primary anastomosis for perforated diverticulitis with purulent or faecal peritonitis (LADIES): a multicentre, parallel-group, randomised, open-label, superiority trial // Lancet Gastroenterol Hepatol. 2019. Vol. 4, № 8. P. 599-610. DOI: 10.1016/S2468-1253(19)30174-8.
78. Halim H., Askari A., Nunn R. et al. Primary resection anastomosis versus Hartmann's procedure in Hinchey III and IV diverticulitis // World J Emerg Surg. 2019. Vol. 14. Art. 32. DOI: 10.1186/s13017-019-0251-4.
79. Vennix S., Boersema G.S., Buskens C.J. et al. Emergency laparoscopic sigmoidectomy for perforated diverticulitis with generalised peritonitis: a systematic review // Dig Surg. 2016. Vol. 33, № 1. P. 1-7. DOI: 10.1159/000441396.
80. Weber D.G., Bendinelli C., Balogh Z.J. Damage control surgery for abdominal emergencies // Br J Surg. 2014. Vol. 101, № 1. P. e109-e118. DOI: 10.1002/bjs.9360.
81. Tartaglia D., Costa G., Camillò A. et al. Damage control surgery for perforated diverticulitis with diffuse peritonitis: saves lives and reduces ostomy // World J Emerg Surg. 2019. Vol. 14. Art. 19. DOI: 10.1186/s13017-019-0238-1.
82. Ordóñez C.A., Sánchez A.I., Pineda J.A. et al. Deferred primary anastomosis versus diversion in patients with severe secondary peritonitis managed with staged laparotomies // World J Surg. 2010. Vol. 34, № 1. P. 169-176. DOI: 10.1007/s00268-009-0279-9.
83. Sohn M., Agha A., Heitland W. et al. Damage control strategy for the treatment of perforated diverticulitis with generalized peritonitis // Tech Coloproctol. 2016. Vol. 20, № 8. P. 577-583. DOI: 10.1007/s10151-016-1498-3.
84. Li D., Baxter N.N., McLeod R.S. et al. Evolving practice patterns in the management of acute colonic diverticulitis: a population-based analysis // Dis Colon Rectum. 2014. Vol. 57, № 12. P. 1397-1405. DOI: 10.1097/DCR.0000000000000230.
85. Feingold D., Steele S.R., Lee S. et al. Practice parameters for the treatment of sigmoid diverticulitis // Dis Colon Rectum. 2014. Vol. 57, № 3. P. 284-294. DOI: 10.1097/DCR.0000000000000075.
86. Strassle P.D., Kinlaw A.C., Chaumont N. et al. Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change // Gastroenterology. 2019. Vol. 157, № 6. P. 1679-1681. DOI: 10.1053/j.gastro.2019.08.043.
87. Morini S. Acute uncomplicated diverticulitis: Guidelines on Diagnosis and Management: is everything fine? // Gastroenterol Hepatol Open Access. 2023. Vol. 14, № 4. P. 127-133. DOI: 10.15406/ghoa.2023.14.00557.
88. Haug C.J., Drazen J.M. Artificial intelligence and machine learning in clinical medicine, 2023 // N Engl J Med. 2023. Vol. 388, № 13. P. 1201-1208. DOI: 10.1056/NEJMra2302038.
Review
For citations:
Timerbulatov Sh.V., Gafarova A.R., imerbulatov V.M. Issues of diagnosis and treatment of acute diverticulitis of the colon (review). Koloproktologia. 2025;24(4):201-208. (In Russ.) https://doi.org/10.33878/2073-7556-2025-24-4-201-208
Views:
9
Email this article 
