Emergency surgery in colonic diverticulitis in an Asian population

Tan, Ker‐Kan; Liu, Jody Zhiyang; Shen, Sharon Fengli; Sim, Richard

doi:10.1007/s00384-011-1160-5

Cited by 14 publications

(20 citation statements)

References 31 publications

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“…In addition, the recurrence rate of RCD of 7% in 7 years follow up in our study, is lower than that reported of LCD (up to 10-20% in 10 years) [4,11,18,33,[37][38][39].…”

Section: Discussioncontrasting

confidence: 73%

“…In the Asian population, colonic diverticulitis is merely a disease of middle aged patients, mostly right-sided, and originating from solitary true congenital diverticula in the cecum. The typical muscular wall hypertrophy seen in LCD, is never present in RCD [9][10][11][12][13][14]. On the contrary, diverticulitis in Caucasians is mainly a disease of the elderly population, commonly left-sided, and originating from multiple acquired pseudo-diverticula [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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Disease Course of Right- and Left-sided Diverticulitis in a Western Population

Wegdam¹,

Andeweg²

2016

J Gastrointest Dig Syst

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Aim: To evaluate the similarities and differences in disease courses between right-and left-sided diverticulitis in a Western population. Methods:All consecutive patients admitted in a Dutch regional hospital between 2004 and 2008 for conservative or operative management of clinically and radiologically confirmed acute right-and left-sided diverticulitis were analyzed retrospectively. Diverticulitis was clinically suspect if the patient presented with lower abdominal pain combined with at least one elevated inflammatory parameter (temperature, WBC, CRP or ESR). Diverticulitis was radiologically confirmed if at least US or CT demonstrated signs of acute right-or left-sided diverticulitis. Differences in incidence, patient characteristics, clinical presentation and disease course between the two diagnoses were analyzed. Results:The hospital system yielded 425 patients with a diverticulosis/diverticulitis discharge coding. 57% was excluded because these patients had another diagnosis demonstrated by imaging, besides diverticulosis (19%), had no imaging at all (16%), were elective or referred (7%), were not admitted (4%) or had other reasons (11%). A total of 183 admitted patients with both clinical and radiological confirmed acute colonic diverticulitis were included. The incidence of right-sided diverticulitis was 8%. Patients with right-sided diverticulitis were predominantly female (86% compared to 47% in leftsided diverticulitis, P = 0.05). Median CRP at presentation was lower in right sided diverticulitis, 30 compared to 71 mg/L (P = 0.001). No other differences in clinical presentation, like the severity of diverticulitis, and disease course, like the need for acute surgery, were found between right and left-sided diverticulitis.Conclusions: Disease course of acute right-sided diverticulitis in Caucasians is comparable to left-sided diverticulitis. Left-sided diverticulitis treatment guidelines may also apply for the right-sided diverticulitis in Caucasians.

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“…In addition, the recurrence rate of RCD of 7% in 7 years follow up in our study, is lower than that reported of LCD (up to 10-20% in 10 years) [4,11,18,33,[37][38][39].…”

Section: Discussioncontrasting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Disease Course of Right- and Left-sided Diverticulitis in a Western Population

Wegdam¹,

Andeweg²

2016

J Gastrointest Dig Syst

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“…In contrast, although there were only 7 cases of left-sided diverticulitis in our study, 1 patient had faeculent peritonitis, suggesting that right-sided diverticulitis may take on a more indolent course compared to the left-sided disease. This has been supported in several recent local studies [6][7][8] .…”

Section: Discussionsupporting

confidence: 61%

“…Right-sided diverticulitis was determined as lesions arising from the caecum to the transverse colon [7,8] . Hinchey's classification was used to grade the severity of the diverticulitis [9,10] .…”

Section: Methodsmentioning

confidence: 99%

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There Is No Role for Colonoscopy after Diverticulitis among Asian Patients Less than 50 Years of Age

Chan

Tan

2016

Gastrointest Tumors

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Background: Colonoscopy is advocated following acute diverticulitis to ensure that malignancy is not missed. In an Asian population, diverticulitis is more common in the right colon and in younger patients. The purpose of this study is to examine the utility of colonoscopy amongst Asian patients <50 years of age who have had colonic diverticulitis. Methods: A retrospective review of all patients aged 50 years and under who were treated for colonic diverticulitis between 2012 and 2014 was performed. All patients were advised to undergo a colonoscopy when the diverticulitis had settled, and findings at colonoscopy were recorded. Results: Fifty-five patients aged <50 years had acute diverticulitis. Forty-eight (87.3%) had right-sided diverticulitis. Amongst them, 45 (93.8%) had Hinchey 1a, 1b or 2 diverticulitis, while none had Hinchey 4 diverticulitis. Excluding the only patient that underwent a colonic resection, 27 (50.0%) patients returned for a colonoscopy. None of these patients were found to have colorectal cancer or an advanced adenoma. Six (11.1%) of them had adenomas with low-grade dysplasia. Conclusion: Right-sided diverticulitis is more common in the young Asian population. Most patients can be conservatively treated. Follow-up colonoscopy may not be required in these patients.

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