Recurrence of Uncomplicated Diverticulitis: A Meta-Analysis

Kang, Gyu-Hong; Son, Seung Hyun; Shin, Young Min; Pyo, Jung‐Soo

doi:10.3390/medicina58060758

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…Nearly 20% of those with diverticula will experience a symptomatic episode of acute diverticulitis [17]. The incidence of recurrence is about one-third, which is in line with our results [18].…”

Section: Discussionsupporting

confidence: 91%

“…Nearly 20% of those with diverticula will experience a symptomatic episode of acute diverticulitis [17]. The incidence of recurrence is about one‐third, which is in line with our results [18]. The incidence of acute diverticulitis in transplant patients was not well established prior to this study but is estimated at 0.4%–6.2%; of these episodes an estimated 40% are severe [8].…”

Section: Discussionsupporting

confidence: 83%

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Treating acute diverticulitis in pre‐ and post‐solid‐organ transplant patients: a single‐institution cohort study

et al. 2023

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Aim: Immunosuppressed patients are more likely to fail nonoperative management of acute diverticulitis and have more postoperative complications than the immunocompetent. Transplant recipients form a subcategory among the immunosuppressed with unique challenges. The aim of this work is to report 30-day postoperative complications after colectomy for acute diverticulitis and success rates of nonoperative management in pre-and post-transplant patients.Method: This is a retrospective cohort study at a single-institution tertiary referral centre. Patients with a history of acute diverticulitis were extracted from a database of 6152 recipients of solid-organ abdominal transplant between 2000 and 2015 and stratified by the index episode of diverticulitis: before or after solid-organ transplant surgery.Outcomes included 30-day postoperative complications and failure of nonoperative management.Results: Acute diverticulitis occurred in 93 patients, 69 (74%) posttransplant.Postcolectomy complications were higher posttransplant than pretransplant (43% vs. 13%, p = 0.04). Posttransplant status was not an independent risk factor for complications (odds ratio 3.59, 95% CI 0.79-16.31) when adjusting for sex and surgical acuity.Immediate urgent colectomy (29% vs. 31%, p = 0.84) and failure of nonoperative management (7% vs. 9%, p = 0.82) were similar. Complications occurred equally in those requiring urgent colectomy after nonoperative management and those undergoing immediate urgent colectomy. Conclusion:Urgent colectomy rates are similar in solid-organ abdominal transplant recipients pre-and posttransplant. Posttransplant complication rates appear to be increased but transplant status as an independent factor is not significantly associated with an increased risk in this study cohort. These findings should be considered when counselling patients on the relative risks and benefits of surgical intervention for diverticulitis before versus after solid-organ transplantation.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 83%

Treating acute diverticulitis in pre‐ and post‐solid‐organ transplant patients: a single‐institution cohort study

et al. 2023

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Acute diverticulitis: beyond the diagnosis: predictive role of CT in assessing risk of recurrence and clinical implications in non-operative management of acute diverticulitis

Simonetti,

Lanciotti,

Carlomagno

et al. 2024

Radiol med

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Purpose The aim of the study is to identify CT findings that are predictive of recurrence of acute uncomplicated colonic diverticulitis, to better risk-stratify these patients for whom guidelines recommend a conservative outpatient treatment and to determine the appropriate management with an improvement of health costs. Materials and Methods Over the past year, 33 patients enrolled in an outpatient integrated care pathway (PDTA) for uncomplicated acute diverticulitis with 1-year follow-up period, without recurrence, and 33 patients referred to Emergency Department for a recurrent acute diverticulitis were included. Images of admission CT were reviewed by two radiologists and the imaging features were analyzed and compared with Chi-square and Student t tests. Univariate and multivariate Cox regression models were employed to identify parameters that significantly predicted recurrence in 1-year follow-up period and establish cutoff and recurrence-free rates. The maximally selected rank statistics (MSRS) were used to identify the optimal wall thickening cutoff for the prediction of recurrence. Results Patients with recurrence showed a greater mean parietal thickness compared to the group without recurrence (16 mm vs. 11.5 mm; HR 1.25, p < 0.001) and more evidence of grade 4 of peridiverticular inflammation (40% vs. 12%, p = 0.009, HR 3.44). 12-month recurrence-free rates progressively decrease with increasing thickness and inflammation. In multivariate analysis, only parietal thickness maintained its predictive power with an optimal cutpoint > 15 mm that causes a sixfold increased risk of recurrence (HR 6.22; 95% CI, 3.05–12.67; p < 0.001). Beyond thickness and peridiverticular inflammation, predictive value of early recurrence within 90 days from the 1st episode resulted also an Hinchey Ib on admission CT. Conclusions The maximum wall thickening and the grade of peridiverticular inflammation can be considered as predictive factors of recurrence and may be helpful in selecting patients for a tailored treatment to prevent the risk of recurrence.

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Non-antibiotic treatment of uncomplicated acute diverticulitis is applicable and safe in our environment. A prospective multicenter study

Serrano González,

Román García de León,

Galindo Jara

et al. 2023

Rev Esp Enferm Dig

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Recurrence of Uncomplicated Diverticulitis: A Meta-Analysis

Cited by 3 publications

References 42 publications

Treating acute diverticulitis in pre‐ and post‐solid‐organ transplant patients: a single‐institution cohort study

Treating acute diverticulitis in pre‐ and post‐solid‐organ transplant patients: a single‐institution cohort study

Acute diverticulitis: beyond the diagnosis: predictive role of CT in assessing risk of recurrence and clinical implications in non-operative management of acute diverticulitis

Non-antibiotic treatment of uncomplicated acute diverticulitis is applicable and safe in our environment. A prospective multicenter study

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