Acute diverticulitis Diagnosis and management Antibiotic therapy Administer oral or IV antibiotics and implement dietary modification in most patients with diverticulitis who are managed nonoperatively. B Antibiotic therapy Consider the use of antibiotics selectively, rather than routinely, in patients with acute uncomplicated diverticulitis. C Percutaneous drainage of diverticular abscesses ASCRS Q Is the patient clinically stable, without peritonitis? Q Does the patient have a large diverticular abscess? Yes to all Perform image-guided percutaneous drainage in stable patients with large diverticular abscesses. B No to any Emergency colectomy ASCRS Q Does the patient have diffuse peritonitis? Q Is the response to nonoperative management inadequate? Yes to any Perform urgent sigmoid colectomy in patients with diffuse peritonitis, or if nonoperative management of acute diverticulitis fails. B No to all Continue treatment as clinically appropriate.