Emergency surgery for colonic diverticulitis: differences between right-sided and left-sided lesions

Background and aims: Right-sided diverticulitis is rare in Western societie s but is not uncommon in Asian countries. Many of the patients are operated with the presumptive diagnosis of appendicitis. This study compared the re sults of emergency surgery for patients with right-sided and left-sided div erticulitis. Patients and methods: Demographic data, type of operation, and surgical outcome were recorded in 60 patients who had undergone emergency surgery for colonic diverticulitis (37 right-sided, 23 left-sided). Results : Patients with right-sided disease were significantly younger (mean age 41 .9 vs. 74.2), and there was a tendency to male predominance (78.4% vs. 56.5 %). All patients with right-sided disease had localized peritonitis while 7 4% of patients with perforated left-sided diverticulitis had generalized fa ecal or purulent peritonitis. Mortality rates for right-sided disease and l eft-sided disease were 0% and 13%, respectively, and morbidity was 14.2% an d 61%, respectively. Longer hospital stay was also found in patients with l eft-sided diverticulitis. Conclusions: There are major differences in the d emographics, presentation, type of operation and outcome of patients who ha d emergency surgery for colonic diverticulitis, with emergency operation fo r left-sided diverticulitis being associated with higher mortality and morb idity.