Summary

The prevalence of diverticular disease in Chile is estimated at 28% and its presentation as complicated diverticulitis is increasingly frequent. In recent years, evidence has emerged that has led to a reconsideration of the management of acute diverticulitis. Historically, antibiotics have been the mainstay of treatment for acute diverticulitis; however, recent evidence shows that patients with an episode of uncomplicated acute diverticulitis can be treated without them. Regarding surgical management, emergency surgery is indicated in diffuse peritonitis, non-punctureable abscess associated with sepsis and treatment failure; both Hartmann surgery and resection and primary anastomosis are valid options depending on the setting. Elective surgery should be indicated on a case-by-case basis and a laparoscopic approach should be chosen whenever possible. When dealing with immunosuppressed patients, one must be more aggressive in management. The indication for colonoscopy after an episode of acute diverticulitis is reserved for patients in whom it has presented as an episode of complicated diverticulitis, in those who should be screened for colorectal cancer, and in those who present symptoms or signs suggestive of colorectal neoplasia.