Which of the following patients generally does not require surgical intervention as a consequence of acute diverticulitis?

C. A 55-year-old woman with hypertension and diabetes mellitus.

DISCUSSION: The majority of patients with diverticular disease are elderly and often have comorbid illnesses. The prognosis in these patients depends on the severity of the underlying inflammatory lesion. Certain subsets of patients, however, have been identified whose overall prognosis is worse. Patients younger than 40 years have a higher incidence of complications, as about 70% eventually require surgical intervention. Patients undergoing renal transplantation are routinely immunosuppressed. Such patients do not manifest the usual signs and symptoms of an inflammatory response. Delays in diagnosis and failure of the normal immune response mandates surgical intervention in virtually all of these patients. The presence of pneumaturia is strongly suggestive of a colovesical fistula. All such fistulas require resection of the diseased colon and repair the involved bladder. Patients with right-sided diverticulitis are usually misdiagnosed as acute appendicitis and, therefore, often are not diagnosed until laparotomy.