We continue to struggle with the perfect definition of the indication for an elective operation in the patient with diverticulitis. Simianu et al,1 in their review of the MarketScan Commercial Claims and Encounters Database, have attempted to determine the influences that drive early and late operation on patients with diverticulitis. The group from University of Washington, Swedish Hospital of Seattle, and Virginia Mason Clinic hypothesized that patients commonly undergo early (<3 episodes) elective resection for diverticulitis, especially when the patient is young and responsible for the cost of the operation, which is done laparoscopically, and the preceding episodes have been frequent over a short period. Simianu et al concluded that none of these factors influenced the decision to operate and at least 50% of patients had early operations.
Fleshman J. Improving Treatment of Uncomplicated DiverticulitisThe Old Appendicitis. JAMA Surg. 2016;151(7):611. doi:10.1001/jamasurg.2015.5552