Treatment of acute diverticulitis and appraisal of evidence

Acute diverticulitis is a common diagnosis in patients with acute abdominal pain. It is characterized by inflammation of diverticula of the colon and occurs in a variety of stages. Two-third of patients present with uncomplicated diverticulitis (peridiverticular inflammation), one-third of patients have complicated diverticulitis (abscess, perforation, colonic obstruction or fistula) at presentation. This thesis mainly focusses on patients with uncomplicated diverticulitis. Part 1 of this thesis assesses the role of antibiotics in uncomplicated diverticulitis. Part 2 studies the borderline between uncomplicated and complicated diverticulitis by assessing risk factors for progression into complicated diverticulitis of initially uncomplicated diverticulitis and by assessing the natural course of patients with mild diverticular complications such as isolated pericolic extraluminal air or small abscesses. Part 3 summarizes current evidence on several issues that have been topic of debate in recent years.