A focus of therapeutic strategies in acute diverticulitis with distant free air: a systematic review

Acute diverticulitis (AD) is a significant socioeconomic burden on healthcare systems, primarily due to elevated rates of hospital admissions and considerable healthcare expenditures. The aim of this systematic review is to update and sum- marise existing knowledge regarding the viability of conservative management in 2B stage cases (distant free extralu- minal air) that remains a crucial condition for surgeons to decide for operative or non-operative management. Patients ages ranging between 52.2 and 60.5 years. Male patients varied from 47 to 73.4%. BMI ranged from 25.7 to 27.1 kg/m2 , and ASA scores between I and III. Antibiotic regimens varied across studies, including mono-antibiotic or bi-antibiotic therapy (average duration from 7 to 21 days). Percutaneous drainage was used in 3.5 to 27.6%. NOM failure ranged from 2.6 to 31.9%, with corresponding emergency surgery rates between 2.17 and 69%. Mortality was low overall. Follow-up durations ranged from 1 to 71 months.