Acute left colonic diverticulitis (ALCD) in the elderly presents with
unique epidemiological features when compared with younger patients. The
clinical presentation is more nuanced in the elderly population, having
higher in-hospital and postoperative mortality. Furthermore, geriatric
comorbidities are a risk factor for complicated diverticulitis. Finally,
elderly patients have a lower risk of recurrent episodes and, in case of
recurrence, a lower probability of requiring urgent surgery than younger
patients. The aim of the present work is to study age-related factors
that may support a unique approach to the diagnosis and treatment of
this problem in the elderly when compared with the WSES guidelines for
the management of acute left-sided colonic diverticulitis. During the 1
degrees Pisa Workshop of Acute Care & Trauma Surgery held in Pisa
(Italy) in September 2019, with the collaboration of the World Society
of Emergency Surgery (WSES), the Italian Society of Geriatric Surgery
(SICG), the Italian Hospital Surgeons Association (ACOI), the Italian
Emergency Surgery and Trauma Association (SICUT), the Academy of
Emergency Medicine and Care (AcEMC) and the Italian Society of Surgical
Pathophysiology (SIFIPAC), three panel members presented a number of
statements developed for each of the four themes regarding the diagnosis
and management of ALCD in older patients, formulated according to the
GRADE approach, at a Consensus Conference where a panel of experts
participated. The statements were subsequently debated, revised, and
finally approved by the Consensus Conference attendees. The current
paper is a summary report of the definitive guidelines statements on
each of the following topics: diagnosis, management, surgical technique
and antibiotic therapy