Transverse colon diverticulitis: Successful nonoperative management in four patients - Report of four cases

PURPOSE: Diverticulitis of the transverse colon is a rare disorder and is o ften confused with other conditions. Previously reported cases of transvers e colon diverticulitis were diagnosed and treated by surgical exploration. Four cases are presented that were successfully managed with a nonsurgical approach. METHODS AND RESULTS: Review of the literature in English disclose d 31 cases of transverse colon diverticulitis. The clinical characteristics and manage ment of these patients are reviewed and compared with the curre nt series of patients. The utility of computerized tomography in the diagno sis of diverticulitis is discussed. CONCLUSIONS: Medical therapy with bowel rest and antibiotics is appropriate for transverse colon diverticulitis wh en free perforation and peritoneal signs are absent and the inflammation is contained, as shown by computerized tomography. Operative exploration shou ld be reserved for patients with diffuse peritonitis or those where perfora ted colon cancer cannot be excluded.