Diverticulitis: The Daily PANCE Blueprint

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Diverticulitis: The Daily PANCE Blueprint

A 52-year-old man presents with left lower quadrant pain and tenderness. CT abdomen shows thickened sigmoid colon with pericolic fat stranding consistent with acute diverticulitis. He has no evidence of abscess, obstruction, or perforation. He is afebrile with normal vital signs and a WBC count of 10,000/μL. Which of the following is the most appropriate management?

A. Hospital admission with IV antibiotics
B. Hospital admission without antibiotics
C. Outpatient management without antibiotic therapy
D. Outpatient management with 7 days of oral antibiotics
E. Outpatient management with 14 days of oral antibiotics

Answer and topic summary

The answer is C) Outpatient without antibiotic therapy

This patient has uncomplicated acute diverticulitis without systemic signs of infection based on clinical and CT findings. Guidelines recommend outpatient management without antibiotics for most immunocompetent patients with mild, uncomplicated acute diverticulitis. Hospital admission and IV antibiotics are reserved for patients with complicated disease or systemic illness. Therefore, outpatient management without antibiotic therapy is most appropriate for this patient with mild, uncomplicated acute diverticulitis.

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Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ Colorectal disorders ⇒ Diverticular disease 

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