Diverticulitis, pelvic and other intra-abdominal abscesses

Diverticular disease is a common condition in the Western world and it carries significant morbidity and healthcare cost. Patients with diverticular disease may present acutely or to out-patients, and the management should be stratified using clinical judgement and appropriate investigation including radiology. Intra-abdominal abscess is a common complication of diverticular disease, but it can also be due to any intra-abdominal organ disease. Conservative management is safe but in the “unwell” patient, other options such as: radiological drainage, laparoscopic washout and drainage, and surgical resection can be life-saving. Careful selection of patients using current stratification tools will help with management. All patients with intra-abdominal abscesses require follow-up and possibly further investigations. This article discusses current evidence and controversies underlying today's management of diverticulitis, diverticular abscess and other intra-abdominal abscesses.