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Of the 26 patients with anastomotic leaks, 5 (19.2%) had a DLI. There was no significant difference in the rate of leak between those with a DLI(5; 6.3%) and those without(21; 5.3%; p = 0.59). Patients who had a DLI were significantly less likely to experience an anastomotic leak requiring re-operation (p 0.01). Regardless of the presence of a DLI, chronic steroid use and smoking are associated with an increased risk of anastomotic leak in patients with acute complicated diverticulitis undergoing colectomy with PA. The presence of