- Complicated diverticulitis (ie, frank perforation, abscess, obstruction, fistula)
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- Sepsis or SIRS (>1 of temperature >38° or <36° Celsius, heart rate >90 beats per minute, respiration rate >20 respirations per minute, white blood cell count >12,000/mL or <4000/mL, C-reactive protein >15 mg/dL)
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- Severe abdominal pain or diffuse peritonitis, and/or failure to reduce abdominal pain in the emergency department to <5 on a VAS
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- Microperforation (eg, a few air bubbles outside of the colon without contrast extravasation or phlegmon)
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- Significant comorbidities (eg, diabetes mellitus with organ involvement [eg, retinopathy, angiopathy, nephropathy], recent cardiogenic event [eg, acute myocardial infarction, angina, heart failure], or recent decompensation of chronic liver disease [≥ Child B] or end-stage kidney disease)
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- Immunosuppression (eg, poorly controlled diabetes mellitus, chronic high-dose corticosteroid use, use of other immunosuppressive agents, advanced HIV infection or AIDS, B or T cell leukocyte deficiency, active cancer of hematologic malignancy, or organ transplant)
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- Intolerance of oral intake secondary to bowel obstruction or ileus
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- Nonadherence with care/unreliability for return visits/lack of support system
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- Failure of outpatient treatment
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