Diverticulitis in the younger patient

West, Sonlee D.; Robinson, Emily K.; Delu, Adam; Ligon, Ralph E.; Kao, Lillian S.; Mercer, David

doi:10.1016/j.amjsurg.2003.08.022

Cited by 41 publications

(41 citation statements)

References 12 publications

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“…This is in line with our results, but the finding of McConnell et al [23] suggesting that young males are more likely to require surgical intervention for fistulas and young females are more likely to present with perforation, is contrary to our results. On the other hand, our results confirm that diverticulitis in young patients does not have a particularly aggressive course, that the risk of recurrence is similar to that of older patients [24,25], and that they should be treated according to the criteria applied to older patients [26]. …”

Section: Discussionsupporting

confidence: 68%

Spectrum of Disease and Outcome among Patients with Acute Diverticulitis

Mäkelä

Kiviniemi²,

Laitinen³

2010

Dig Surg

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Background: This study was designed to evaluate the natural history of patients admitted for acute diverticulitis. Methods: Nine hundred and seventy-seven patients admitted to Oulu University Hospital for acute symptoms of diverticular disease during the 20-year period from 1986 to 2005 were identified using a database. Results: Six hundred and ninety-five patients were admitted for uncomplicated diverticulitis and 282 for complicated diverticulitis. The patients admitted for uncomplicated diverticulitis were younger than the others and 66% of them were admitted only once. The number of admissions preceding perforation was higher in the 1980s, and the number of admissions was unrelated to the degree of perforation or the outcome of the patients. The annual prevalence of sigmoid diverticular perforation increased from 2.6/100,000 in 1986 to 4.2/100,000 in 2005. Seventy (10%) of the 695 patients admitted for the first time for acute diverticulitis underwent urgent surgery during the same admission and 66 (9%) had elective surgery during a later admission. Overall hospital mortality was 2.3%, being 1% among those admitted for acute diverticulitis and 5.5% among those admitted for diverticular perforation. Two hundred and thirty-four (42%) of the 555 nonoperated patients with acute diverticulitis developed a recurrent episode of diverticulitis. The course of recurrent disease was similar to the primary episode. Conclusion: Two or more preceding admissions for acute diverticulitis do not warrant sigmoid resection after diverticulitis. Young patients do not have a greater risk of complicated diverticulitis than older ones.

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Section: Discussionsupporting

confidence: 68%

Spectrum of Disease and Outcome among Patients with Acute Diverticulitis

Mäkelä

Kiviniemi²,

Laitinen³

2010

Dig Surg

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“…4,8,9 New data suggest that the course of diverticulitis in the young is not as virulent as once thought. [9][10][11][12][13] Therefore, treatment recommendations may need to change. Abdominal CT is the diagnostic test of choice in acute diverticulitis.…”

mentioning

confidence: 99%

Management of Diverticulitis in Younger Patients

Nelson

Velasco

Mukesh³

2006

Diseases of the Colon &Amp; Rectum

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“…Epidemiologische Daten belegen einen überproportio-nalen Anstieg der Inzidenz bei jungen Patienten [14,19,30]. Hinsichtlich der Verlaufsform und des therapeutischen Regimes bei jungen Patienten gibt es nach wie vor kontroverse Diskussionen [7][8][9][10][11][12][13][14][15][16]32]. In der aktuellen Literatur findet man in etwa eine gleich große Anzahl von Studien, die für ein konservatives Vorgehen bei Patienten unter 50 Jahren plädie-ren [14,19,23,24], sowie von Studien, die eine Operation empfehlen [23-27, 31, 33].…”

Section: Diskussionunclassified

“…Ob das Alter der Patienten selbst einen Risikofaktor darstellt, wird insbesondere bei jungen Patienten (unter 40 Jahren) mit einer akuten Sigmadivertikulitis kontrovers diskutiert [7][8][9][10][11][12][13][14][15][16]. Ursprünglich wurden durch die Empfehlungen der European Association for Endoscopic Surgery (EAES) [17] und der American Society of Colon and Rectal Surgeons (ASCRS) [18] für junge Patienten mit einer akuten Sigmadivertikulitis eine Operationsempfehlung ausgesprochen, da diese wegen der rezidivierenden Natur der Erkrankung mit einem hohen Langzeitrisiko für schwere Komplikationen rechnen müssten.…”

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