Long-term management of diverticulitis in young patients

Vignati, Paul V.; Welch, John P.; Cohen, Jeffrey

doi:10.1007/bf02054123

Cited by 98 publications

(67 citation statements)

References 7 publications

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“…Previous studies, including a series by Schauer et al [14], reported 26% of 238 patients to be below 40 years, and 72% of them required an urgent surgical intervention [15]. Although some surgeons recommend an elective resection in young patients after one well-documented episode of uncomplicated diverticulitis, two recent studies and a review paper failed to substantiate a more aggressive nature of diverticulitis in young patients [6, 16, 17]. This could possibly be explained by the lack of long-term prospective studies in the younger population to evaluate the natural history of diverticular disease in this age group.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Acute Admissions in a Surgical Unit due to Diverticular Disease

2007

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Introduction: Considerable controversy exists in the surgical literature on the most appropriate treatment modality for patients with recurrent diverticular disease. We aim to assess the clinical outcome of acute surgical admissions with diverticular disease, and in particular patients with recurrent admissions. Methods: 100 consecutive emergency admissions with suspected diverticular disease were prospectively recruited from November 1, 2002 to May 31, 2004. Results: The majority of the patients were female (64%) and the median age was 74 (45–97) years. The follow-up period was up to 30 months. Four patients with tumour and polyps as definitive diagnosis were excluded from further analysis. Fifty-four patients had a known history of diverticular disease with a median duration of 4 (range 1–40) years; 44 of them had 1–7 previous emergency admissions (median 2). Acute diverticulitis (42%) and acute rectal bleeding (23%) were the commonest presentations. Patients with complicated diverticulitis requiring an emergency operation had a median C-reactive protein of 281 mg/l compared to 58 mg/l in the conservatively treated patients with acute diverticulitis (Mann- Whitney U test, Z –3.943, p < 0.001). Nine of 14 patients operated had at least two previous admissions with complications of diverticular disease. Emergency operative treatment was associated with prolonged hospital stay (21 vs. 5 days; Mann-Whitney U test, Z –4.367, p < 0.001), increased morbidity and postoperative mortality. Conclusions: Symptomatic diverticular disease is associated with recurrent emergency admissions. The majority of patients who required emergency laparotomy had previous recurrent emergency admissions, which was associated with increased morbidity and prolonged hospital stay.

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Section: Discussionmentioning

confidence: 99%

A Prospective Study of Acute Admissions in a Surgical Unit due to Diverticular Disease

2007

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“…Aunque no hay evidencia definitiva sobre el tema, un episodio de diverticulitis que responde satisfactoriamente al tratamiento médico en el paciente menor de 40 años, sería para algunos autores una indicación formal de cirugía electiva por ED, considerando que la enfermedad en estos casos tiene un curso más agresivo 17,[22][23][24] .…”

Section: Discussionunclassified

Indicaciones resultados alejados del tratamiento quirúrgico electivo de la enfermedad diverticular del colon sigmoides

C¹,

P²,

L³

et al. 2005

Rev. méd. Chile

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“…Specific data extracted included presenting complaints and physical signs, preoperative diagnosis, laboratory and radiographic findings, length of symptoms before treatment, indications for operative intervention, surgical treatments, and morbidity and mortality. The severity of diverticulitis was assessed using the modified Hinchey's classification [5][6]. Data were evaluated with the statistical SPSS package, version 13.0 (Chicago, IL).…”

Section: Methodsmentioning

confidence: 99%

Cecal diverticulitis mimicking acute appendicitis: Management and short-term results of surgery

Öter¹

2018

Ann Clin Anal Med

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Aim: Cecal diverticulum is an infrequent cause of acute abdomen, and cecal diverticulitis usually presents in a behavior similar to acute appendicitis. This study aims to review our experience with surgical or nonsurgical management of cecal diverticulitis mimicking acute appendicitis in our department. Material and Method: From January 2012 to April 2017, fourteen patients were treated for cecal diverticulitis at our clinic. We retrospectively reviewed the patients' records, imaging modalities, and operative findings.Results: Nine men and five women with a mean age 43.93 ± 8.95 (range 32 to 65) years were evaluated.Total of nine (64.2%) patients were managed operatively. All patients were urgently operated. The mean hospital stay was 6.11 ± 1.61 days. In the postoperative period, two patients had wound infection, and postoperative mortality was not observed. Nonoperative management was used for the treatment in five (35.7%) patients who were preoperatively diagnosed with cecal diverticulitis, Hinchey stage I or II.Conclusion: Inflammation of the diverticulum of the cecum is an uncommon disease, but should be kept in mind in the differential diagnosis of pain in the right lower quadrant. Diagnostic laparoscopy can be used in patients and especially in women with atypical presentations of acute appendicitis. Preoperative diagnosis of cecal diverticulitis is very important in order to decide how to manage this condition.

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Long-term management of diverticulitis in young patients

Abstract: Based on our data, we do not recommend surgery in this population after a single episode of diverticulitis that resolves after treatment with antibiotics.

Cited by 98 publications

References 7 publications

A Prospective Study of Acute Admissions in a Surgical Unit due to Diverticular Disease

A Prospective Study of Acute Admissions in a Surgical Unit due to Diverticular Disease

Indicaciones resultados alejados del tratamiento quirúrgico electivo de la enfermedad diverticular del colon sigmoides

Cecal diverticulitis mimicking acute appendicitis: Management and short-term results of surgery

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