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

Background and aims: Right-sided diverticulitis is rare in Western societies but is not uncommon in Asian countries. Many of the patients are operated with the presumptive diagnosis of appendicitis. This study compared the results of emergency surgery for patients with right-sided and left-sided diverticulitis. 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 74% of patients with perforated left-sided diverticulitis had generalized faecal or purulent peritonitis. Mortality rates for right-sided disease and left-sided disease were 0% and 13%, respectively, and morbidity was 14.2% and 61%, respectively. Longer hospital stay was also found in patients with left-sided diverticulitis. Conclusions: There are major differences in the demographics, presentation, type of operation and outcome of patients who had emergency surgery for colonic diverticulitis, with emergency operation for left-sided diverticulitis being associated with higher mortality and morbidity.