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- Evidence-based clinical practice guidelines for diagnosis and medical management of acute colonic diverticulitis developed by the Korean Association for the Study of Intestinal Diseases (KASID)
- Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Myung-Won You, Kyuwon Kim, Kwang Woo Kim, Yuna Kim, Seong-Eun Kim, Seung-Jae Myung, on behalf of the Clinical Practice Guideline Taskforce of the Korean Association for the Study of Intestinal Diseases
- Received November 28, 2025 Accepted December 28, 2025 Published online June 8, 2026
- DOI: https://doi.org/10.5217/ir.2025.00299 [Epub ahead of print]
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Abstract
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Supplementary Material
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ePub - Acute colonic diverticulitis is a common gastrointestinal inflammatory disorder. The incidence of acute colonic diverticulitis has been steadily increasing in Korea, particularly among younger and middle-aged adults. This rising prevalence, along with the observed differences in clinical characteristics compared to Western populations, underscores the need for region-specific, evidence-based guidance. The Korean Association for the Study of Intestinal Diseases (KASID) established a task force to develop these clinical practice guidelines to optimize the diagnosis and medical management of acute colonic diverticulitis tailored to the Korean healthcare environment. These guidelines were developed through a systematic literature review, critical appraisal of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, and expert consensus via a modified Delphi method. They addressed 12 clinical questions encompassing prognostic factors, diagnostic modalities, initial management for uncomplicated diverticulitis, management of complications, and prevention of recurrence. The resulting recommendations provide clinicians with evidence-based guidance for individualized management based on patients’ condition and values. These guidelines aim to enhance the quality of care and optimize outcomes for patients with acute colonic diverticulitis in Korea.
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Original Article
- Miscellaneous
- Primary epiploic appendagitis: compared with diverticulitis and focused on obesity and recurrence
- Youn I Choi, Hyun Sun Woo, Jun-Won Chung, Young Sup Shim, Kwang An Kwon, Kyoung Oh Kim, Yoon Jae Kim, Dong Kyun Park
- Intest Res 2019;17(4):554-560. Published online October 14, 2019
- DOI: https://doi.org/10.5217/ir.2018.00148
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Abstract
PDFPubReaderePub
- Background/Aims
There is limited data to compare the clinical characteristics and recurrence rates between left-sided primary epiploic appendagitis (PEA) versus left-sided acute colonic diverticulitis (ACD), and right-sided PEA versus right-sided ACD, respectively.
Methods
We retrospectively reviewed the medical records and radiologic images of the patients who presented with left-sided or right-sided acute abdominal pain and had computer tomography performed at the time of presentation showing radiological signs of PEA or ACD between January 2004 and December 2014. We compared the clinical characteristics of left PEA versus left ACD and right PEA versus right ACD, respectively.
Results
Fifty-six patients (left:right = 27:29) and 308 patients (left:right = 24:284) were diagnosed with symptomatic PEA and ACD, respectively. Left-sided PEA were statistically significantly younger (50.2 ± 15.4 years vs. 62.1 ± 15.8 years, P= 0.009), more obese (body mass index [BMI]: 26.3 ± 2.9 kg/m2 vs. 22.3 ± 3.1 kg/m2 , P< 0.001), and had more tendencies with normal or mildly elevated high-sensitivity C-reactive protein (hsCRP) (1.2 ± 1.3 mg/dL vs. 8.4 ± 7.9 mg/dL, P< 0.001) than patients with left-sided ACD. The discriminative function of age, BMI and CRP between left-sided PEA versus left-sided ACD was 0.71 (cutoff: age ≤ 59 years, sensitivity of 66.7%, specificity of 77.8%), 0.83 (cutoff: BMI > 24.5 kg/m2 , sensitivity of 80.0%, specificity of 80.0%) and 0.80 (cutoff: CRP < 1.8 mg/dL, sensitivity of 72.2%, specificity of 85.7%).
Conclusions
If patients with left lower quadrant abdominal pain are less than 60 years, obese (BMI > 24.5 kg/m2 ) with or without normal to mild elevated CRP levels (CRP < 1.8 mg/dL), it might be necessary for clinicians to suspect the diagnosis of PEA rather than ACD. -
Citations
Citations to this article as recorded by
- Descending Colon Epiploic Appendagitis Mimicking Diverticulitis: A Case Report
Anas E Ahmed, Omar G Alahmadi, Abdullah H Althurwi, Osaid H Niazi, Yazen A Alomary
Cureus.2026;[Epub] CrossRef - The role of laboratory parameters in discriminating between acute diverticulitis and acute epiploic appendagitis: a comprehensive analysis
Fatih Şahin, Ramazan Topcu, Mehmet Berksun Tutan
Journal of Medicine and Palliative Care.2026; 7(1): 71. CrossRef - TREATMENT OF PATIENTS WITH EPIPLOIC APPENDAGITIS
D. V. Sininkina, A. V. Vinogradov, A. V. Maksimenkov
Bulletin of Pirogov National Medical & Surgical Center.2026; 21(2): 44. CrossRef - Epiploic Appendagitis Following Blunt Abdominal Trauma: A Case Report with Literature Review
Ayah Obeid, Douglas Degler
ASIDE Case Reports.2025; 1(2): 6. CrossRef - From CT to Cytokines: Evaluating the Role of Systemic Inflammation and Metabolic Markers in Epiploic Appendagitis
Şeref Barbaros Arik, İrfan Esen, Oğuzhan Özdemir
Bratislava Medical Journal.2025; 126(12): 3709. CrossRef - Characteristic CT Imaging Features of Atraumatic Peritoneal and Subperitoneal Pathologies in Emergency Settings: A Pictorial Review
Christopher D Louviere, Jennifer L Wen, Neal M Hall, Ruben G Ortiz, Dheeraj R Gopireddy, Grit A Adler, Renato Abu Hana
Cureus.2025;[Epub] CrossRef - Diagnosis and treatment of epiploic appendagitis in a Middle Eastern country: An observational retrospective analysis of 156 cases
Ayman El‐Menyar, Syed G. A. Naqvi, Omer Al‐Yahri, Abdelaziz MA Abusal, Abdulwahhab Al‐Shaikhli, Sadia Sajid, Husham Abdelrahman, Ahmad G. Kloub, Muhamed Ibnas, Rifat Latifi, Yasser M. R. Toble, Hassan Al‐Thani
World Journal of Surgery.2024; 48(6): 1363. CrossRef - Epiploic Adipose Tissue (EPAT) in Obese Individuals Promotes Colonic Tumorigenesis: A Novel Model for EPAT-Dependent Colorectal Cancer Progression
Rida Iftikhar, Patricia Snarski, Angelle N. King, Jenisha Ghimire, Emmanuelle Ruiz, Frank Lau, Suzana D. Savkovic
Cancers.2023; 15(3): 977. CrossRef - Recurrencia en pacientes con apendagitis epiploica: un reporte de caso
Mía Alejandra Gómez Corrales, Fabian Andrés Chávez Ecos, Jackeline Alexandra Espinoza Utani, Carlos Alberto Dávila Hernández
Revista colombiana de Gastroenterología.2023; 38(1): 94. CrossRef
- Descending Colon Epiploic Appendagitis Mimicking Diverticulitis: A Case Report
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