A 10-year comparison of right versus left colonic diverticulitis in an Asian center

Abstract

Background and Aim: The incidence of right-sided diverticulitis is much higher in Asians compared to Caucasians. The aim of this study was to determine and compare the outcome of right colonic diverticulitis with those of left-sided disease. Methods: Retrospective review of patients admitted with diverticulitis from 2004 to 2014 to a tertiary referral unit. Patient demographics, Hinchey classification, need for emergency surgery, and perioperative outcome were analysed and compared. Results: In total 360 patients presented with diverticulitis, of which 260 (72%) were right-sided disease. The mean age was 61 years, 159 (44.2%) patients were male; 201 (55.8%) were female. All patients complained of abdominal pain while leukocytosis and fever were present in 73% and 36% of patients, respectively. The mean hospital stay was 9.4 days. The majority of patients (93%) were Hinchey grade I and II. There was no significant difference in sex, Hinchey class, or the need for emergency surgery between the 2 groups. One hundred patients (28%) underwent emergency surgery. Sixty-seven (25.7%) right-sided patients required emergency surgery; however, 54 (81%) of these were based on a presumptive clinical diagnosis of acute appendicitis. Postoperative morbidity was significantly higher in left-sided diverticulitis (70.6% vs 29.4%, P = 0.001). There was no significant difference in operative mortality. Conclusion: Right-sided diverticulitis is an important clinical diagnosis in the Asian population. Clinical presentation can often mimic acute appendicitis. When emergency surgery is required, right-sided diverticulitis is associated with a lower operative morbidity compared to left-sided disease.