Acute Uncomplicated Diverticulitis: Updated Evidence for Same Old Questions

CASE SUMMARY: A 58-year-old man with a previous history of hypertension presented to the emergency department because of acute left lower quadrant pain. Neither nausea nor vomiting was described. At physical examination, he had tenderness to palpation in the left lower quadrant with no signs of peritonitis. The patient's body temperature and heart rate were unremarkable (37.2°C/86 beats per minute). Laboratory blood tests showed minimal leukocytosis (13,000 cells/mm 3 ) with no other relevant findings. An abdominal CT was performed, which confirmed the clinical suspicion of acute uncomplicated diverticulitis (AUD). It was described as the presence of a sigmoid thickening and phlegmon in an area with several diverticula, but no free air, fluid, or abscesses were identified ( Fig. 1 ). After the administration of painkillers, the patient remained completely asymptomatic, with good pain control and no fever, so he was recommended conservative outpatient treatment without antibiotics. One week after the AUD episode, the patient was checked, and he confirmed that the resolution had been uneventful and he had been asymptomatic, confirming that the outpatient treatment was successful. The patient asked for any measures that he could follow to prevent further episodes and showed interest in surgical treatment options.