ABSTRACT
The incidence of diverticulosis has increased in Western societies over the last century and has paralleled industrialization as well as increased consumption of refined products with reduced dietary fiber. Acute diverticulitis occurs in a small subset of individuals with diverticulosis, and the majority of attacks occur in the sigmoid colon. Acute diverticulitis can present in both uncomplicated and complicated fashions. Most of the controversies and proposals for new therapeutic approaches in diverticular disease of the colon have centered on the management of complicated diverticulitis that requires emergent operative intervention. The long-standing treatment approach in complicated diverticulitis with perforation has been the Hartmann procedure—resection of the sigmoid colon, leaving a rectal stump and a sigmoid colostomy. The management of acute diverticulitis continues to evolve. Practice patterns will correspondingly continue to change as more clinical trials and high-quality data on the subject is published.
