Acute diverticulitis: surgery timing in elderly patients

Background Diverticular disease is common among the elderly. Its management is complex and offers multiple treatment options. Findings Uncomplicated acute diverticulitis is treated with initial conservative therapy, while cases of recurrence are approached with surgery. Perforated acute diverticulitis (Hinchey I and II) it usually treated with apercutaneous drainage followed by elective colonic resection. Therapeutic failure of percutaneous drainage is an indication for emergency surgery. Acute diverticulitis with peritonitis (Hinchey III and IV) requires emergency surgery. The surgical options are two: one-step or two-step operation. According to the data present in literature one-step operation has a lower mortality and complication rate than the two-step operation approach. Conclusions Acute diverticulitis is a condition that requires surgical management. The timing and the surgical technique depend on the single clinical situation.