Aquina CT, et al. - Researchers performed this observational cohort study to assess outcomes following elective colectomy vs non-operative management after admission for an initial acute diverticular abscess. They queried the Statewide Planning and Research Cooperative System identifying 10,342 patients with an initial acute diverticular abscess. Surgical management was undertaken in one-third (3,270) of these even with initial non-operative management within 30 days. Among the remaining 7,072 patients, elective colectomy was done in 1,660 within 6 months. Non-operative management of 5,412 patients was done, 1,340 (24.8%) of these had recurrence of diverticulitis within 5 years. They noted higher stoma rates, as well as more inpatient hospital days for diverticulitis-related admissions and higher mean diverticulitis-related costs among patients who underwent elective colectomy. These findings suggest that following resolution of an initial diverticular abscess, observation without elective colectomy is a practical option with lower healthcare costs vs operation.