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Behind The Knife: The Surgery Podcast

Journal Review in Colorectal Surgery: Management of Acute Uncomplicated Diverticulitis With or Without Antibiotics

Behind The Knife: The Surgery Podcast

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 15 September 2025

⏱️ 30 minutes

🧾️ Download transcript

Summary

Why are we still treating acute uncomplicated diverticulitis with antibiotics? There is plenty of evidence from several randomized controlled trials demonstrating that symptomatic management alone yields similar results. If we should continue prescribing antibiotics for acute uncomplicated diverticulitis, which patients should undergo treatment and when? Join Drs. Jared Hendren, Elissa Dabaghi, Joseph Trunzo, Ajaratu Keshinro, and David Rosen as they discuss the management of uncomplicated diverticulitis while reviewing groundbreaking literature.

Hosts:
-Jared Hendren, MD
Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
- Elissa Dabaghi, MD
Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
- Joseph Trunzo, MD
Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute,
Cleveland Clinic Foundation, Cleveland, Ohio
Social Media Handle: X/Twitter @joseph_trunzo
- Ajaratu Keshinro, MD
Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute,
Cleveland Clinic Foundation, Cleveland, Ohio
Social Media Handle: X/Twitter- @AJKesh
- David Rosen, MD
Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute,
Cleveland Clinic Foundation, Cleveland, Ohio
Social Media Handle: X/Twitter- @davidrrosenmd

Learning Objectives: By the end of this episode, listeners will be able to:
1.     Identify criteria for managing acute uncomplicated diverticulitis without antibiotics based on recent literature
2.     Define uncomplicated and complicated diverticulitis
3.     Discuss nuanced management decisions of patients with uncomplicated diverticulitis to determine when antibiotics may be appropriate for management

References:
1.     Azhar, N., Aref, H., Brorsson, A., Lydrup, M.‑L., Jörgren, F., Schultz, J. K., & Buchwald, P. (2022). Management of acute uncomplicated diverticulitis without antibiotics: Compliance and outcomes – a retrospective cohort study. BMC Emergency Medicine, 22(1), Article 28. https://doi.org/10.1186/s12873‑022‑00584‑X 
2.     Mora‑López, L., Ruiz‑Edo, N., Estrada‑Ferrer, O., Piñana‑Campón, M. L.,
Labró‑Ciurans, M., Escuder‑Perez, J., Sales‑Mallafré, R., Rebasa‑Cladera, P.,
Navarro‑Soto, S., Serra‑Aracil, X., & DINAMO‑study Group. (2021). Efficacy and safety of nonantibiotic outpatient treatment in mild acute diverticulitis (DINAMO‑study): A multicentre, randomised, open‑label, noninferiority trial. Annals of Surgery, 274(5), e435–e442. https://doi.org/10.1097/SLA.0000000000005031
3.     Daniels, L., Ünlü, Ç., de Korte, N., van Dieren, S., Stockmann, H. B., Vrouenraets, B. C., Consten, E. C., van der Hoeven, J. A., Eijsbouts, Q. A., Faneyte, I. F., Bemelman, W. A., Dijkgraaf, M. G., & Boermeester, M. A. (2017). Randomized clinical trial of
observational versus antibiotic treatment for a first episode of CT‑proven uncomplicated acute diverticulitis. British Journal of Surgery, 104(1), 52‑61. https://doi.org/10.1002/bjs.10309
4.     Chabok, A., Påhlman, L., Hjern, F., Haapaniemi, S., & Smedh, K.; AVOD Study Group. (2012). Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. British Journal of Surgery, 99(4), 532–539. https://doi.org/10.1002/bjs.8688

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Transcript

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0:00.0

Behind the Night, the Surgery Podcast, relevant and engaging content designed to help you

0:11.6

dominate the day.

0:23.6

Hi, all you, BTCK listeners. It's Scott here.

0:24.6

Want to talk a little bit about our colorectal surgery oral board audio review.

0:29.6

With upwards of 50 plus high-ield scenarios designed for colorectal surgeons by colorectal surgeons,

0:36.6

the scenarios are five to seven

0:38.2

minutes long, a variety of tactical styles. We also have a high-yield commentary to each

0:43.9

scenario. It includes tips and tricks that help you dominate the most challenging scenarios.

0:49.9

In addition to practical, easy to think through, easy to understand, teaching style that covers the

0:54.8

most confusing, the most interesting, and the most basic of topics that we all face as

0:59.7

colorectal surgeons. So we are confident that you will find this unique, dual format approach,

1:05.3

highly effective way to prepare for your test. Check it out, behindtheknife.org.

1:15.6

Hey everyone and welcome to Behind the Knife. I'm Melissa DeBoggi, a general surgery resident at the Cleveland Clinic. And I'm Jared Hendren, another general surgery resident at Cleveland

1:19.6

Clinic, and we're joined by members of our colorectal surgery team.

1:22.6

My name is Dave Rosen. I'm the section head of colorectal surgery at Cleveland Clinic Fairview Hospital and joined by a couple of my colleagues on my incredible team here.

1:33.3

I'm Adiratsu, Kishina. I go by AJ. I'm one of the assistant professor at the Fairview Hospital, one of Dr. Rosen partners.

1:42.3

And I'm Joe Transo. I'm one of the

1:44.6

associate program directors of the General Surgery Residency Program here at the Cleveland Clinic

1:47.7

and part of the Westside colorectal team. All right, great. So the topic we're discussing

1:52.4

today is the management of acute uncomplicated diverticulitis. Why are we still treating these

1:57.0

patients with antibiotics? There's been so many studies in randomized control trials

2:01.0

showing no benefit, though we've been doing this for years. A 22 study in Sweden found that only

...

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