What criteria should I use to decide whether to refer a patient with diverticulitis for surgical evaluation?

Refer for surgical evaluation in cases of complicated acute diverticulitis, such as when there is an intra-abdominal abscess, bowel perforation, peritonitis, fistula formation, or intestinal obstruction, which require urgent surgical intervention ¹.

Consider referral if the patient has persistent or recurrent episodes of diverticulitis, especially if episodes are severe or frequent, or if there are complications such as stricture or fistula formation ².

Patients who are immunocompromised or have significant comorbidities at high risk of complications may also require surgical assessment ¹.

Additionally, if the patient does not improve with medical treatment or presents with features suggestive of complicated diverticulitis, they should be referred for surgical evaluation ¹.