Management of Uncomplicated Diverticulitis: A Systematic Review on Outpatient versus Inpatient Treatment

Abstract

Introduction: Traditionally, acute uncomplicated diverticulitis has been managed with inpatient admission, bowel rest, and intravenous antibiotics. A shift towards outpatient management for select patients has occurred. This review evaluates the safety and efficacy of this approach.

Methods: A systematic search of RCTs and prospective cohort studies was performed. We included studies that compared outpatient versus inpatient management for patients with CT-confirmed, non-abscessed, uncomplicated acute diverticulitis. The primary outcome was the treatment failure rate.

Results: The analysis of 15 studies showed no significant difference in the treatment failure rate between outpatient and inpatient management for selected patients. Outpatient treatment was associated with significant cost savings and improved patient satisfaction without increasing the rate of complications or need for emergency surgery.

Discussion: In hemodynamically stable, immunocompetent patients without signs of complicated disease who can tolerate oral intake, outpatient management of acute diverticulitis is a safe and effective alternative to routine hospitalization. Careful patient selection is paramount.

Conclusion: Outpatient management is a safe and effective strategy for selected patients with acute uncomplicated diverticulitis.