Вопросы диагностики и лечения острого дивертикулита ободочной кишки (обзор литературы)
https://doi.org/10.33878/2073-7556-2025-24-4-201-208
Аннотация
В обзоре литературы освещены современные подходы к диагностике и выбору метода лечения острого дивертикулита ободочной кишки. Рассмотрены значимость, эффективность клинико-лабораторных и визуализационных методов исследования. Ультразвуковое исследование и компьютерная томография в настоящее время являются наиболее точными методами диагностики острого дивертикулита, с чувствительностью 85–97%, специфичностью 90–99%. Особое внимание уделено хирургической тактике при осложненном дивертикулите, роли и месту чрескожных вмешательств, различным вариантам резекции ободочной кишки, в том числе лапароскопическим доступом.
Ключевые слова
Об авторах
Ш. В. ТимербулатовРоссия
Тимербулатов Шамиль Вилевич — д.м.н., профессор кафедры хирургии и эндоскопии
ул. Ленина, д. 3, г. Уфа, 450008
А. Р. Гафарова
Россия
Гафарова Айгуль Радиковна — к.м.н., ассистент кафедры хирургии и эндоскопии
ул. Ленина, д. 3, г. Уфа, 450008
В. М. Тимербулатов
Россия
Тимербулатов Виль Мамилович — д.м.н., профессор, член-корр. РАН, заведующий кафедрой хирургии и эндоскопии
ул. Ленина, д. 3, г. Уфа, 450008
Список литературы
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.
Рецензия
Для цитирования:
Тимербулатов Ш.В., Гафарова А.Р., Тимербулатов В.М. Вопросы диагностики и лечения острого дивертикулита ободочной кишки (обзор литературы). Колопроктология. 2025;24(4):201-208. https://doi.org/10.33878/2073-7556-2025-24-4-201-208
For citation:
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






























