The Effects of Diverticulum Localization and Hinchey Classification on Recurrence and Complications in Acute Colonic Diverticulitis

Demircioglu, Mahmut Kaan; Demircioglu, Zeynep Gul; Celayir, Mustafa Fevzi; Kaya, Cemal; Mihmanlı, Mehmet

doi:10.14744/semb.2020.03453

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…There are also studies showing that the localization of the diverticulum may be one of the factors that may play a role in the severity and recurrence of the disease. [ 24 ] In our study, 95% of the patients had diverticulitis located in the sigmoid colon. In 65% of the patients, the diverticula are found only in the sigmoid colon and in 24% in other parts of the colon together with the sigmoid colon.…”

Section: Discussionmentioning

confidence: 54%

Management of Acute Uncomplicated Diverticulitis: Inpatient or Outpatient

et al. 2022

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Objectives: Diverticular disease is a highly frequent condition and affects 50% of the population in the 9th decade in Western society. Acute diverticulitis is the most prevalent complication. The patients who are clinically stable and tolerate fluid should be hospitalized if fluid intake tolerance worsens, fever occurs, or pain increases. Bowel rest, intravenous fluid therapy, and empiric antibiotic therapy are the traditional treatments for patients admitted to the hospital. This retrospective study aimed to determine the parameters that will affect the outpatient or inpatient treatment of patients diagnosed with uncomplicated acute diverticulitis. Methods: Patients who presented to the emergency department with abdominal pain between January 2018 and December 2020 and were diagnosed with uncomplicated diverticulitis (modified Hinchey 1a) on computed tomography (CT) taken after intravenous contrast material shoot up were included in the study. Patient records were recorded retrospectively in the Excel file. After being seen in the emergency department, a comparison was performed between the inpatient group (Group 1) and the outpatient follow-up group (Group 2). Results: The study comprised 172 patients with acute uncomplicated diverticulitis (modified Hinchey 1a). While 110 (64.0%) patients were followed up and treated as inpatients (Group 1), 62 (36.0%) patients were followed up as outpatients (Group 2). There was no statistically significant difference between the two groups in terms of patients readmitted to the hospital in the first 30 days after discharge (both for outpatient follow-up in the emergency department and after treatment in the inpatient group). Conclusion: In this retrospective study, in which we evaluated the hospitalization criteria in uncomplicated Modified Hinchey 1a patients, it was found that patients can be safely treated as an outpatient if they have poor physical examination findings. Although there was no difference between the two groups in terms of hospital readmission after discharge and it was thought that follow-up of patients with Modified Hinchey 1a diverticulitis with outpatient oral antibiotic therapy might be reliable, prospective studies with larger numbers of patients are needed.

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Section: Discussionmentioning

confidence: 54%

Management of Acute Uncomplicated Diverticulitis: Inpatient or Outpatient

et al. 2022

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“…Additionally, we found that right sided diverticular location was associated with a higher occurrence of diverticulitis (OR 1.97, P = 0.02), as their BMI was significantly higher than patients with right sided colonic diverticulosis but without diverticulitis (31.1 vs. 28.2 kg/m 2 , respectively, P = 0.01). Previous study reported that rectosigmoid location is an important factor for recurrence and for acute diverticulitis prognosis [29]. Therefore, further studies are needed to accurately assess diverticulosis location on the rate and prognosis of diverticulitis.…”

Section: Discussionmentioning

confidence: 98%

The impact of overweight on diverticular disease: a cross-sectional multicentre study

Mari¹,

Sbeit²,

Haddad³

et al. 2021

Polish Archives of Internal Medicine

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The main finding of this study is the possible link between overweight and the increased risk of acute diverticulitis among patients with asymptomatic diverticulosis. This observation has special practical applications since overweight is a modifiable factor. The finding of this study open horizons for prospective studies on the effects of weight loss as an optional treatment for symptomatic diverticular disease.

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“…Understanding the pattern of complication presentation and successful medical management in this younger population can help guide treatment algorithms that can help prevent unnecessary intervention. This differentiation is vital in the process of developing treatment guidelines for diverticulitis in patients under 40 years, as the common treatments for complicated vs uncomplicated diverticulitis vary drastically in terms of invasiveness, hospitalization length-of-stay, and cost of treatment [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Diverticulitis in the Under-40 Population

Jacqueline,

Lince,

DeMario

et al. 2024

Cureus

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Background: As obesity and lifestyle factors become more prevalent in younger populations, we are diagnosing and treating diverticulitis in younger patients. In this study, the demographics, risk factors for the development, and treatment of acute diverticulitis were assessed focusing on patients under the age of 40. Methods: A retrospective review of the electronic medical records of a cohort of subjects diagnosed with diverticulitis was performed. Inclusion criteria included patients aged 18-40 who were treated for acute diverticulitis with or without any complications. Results: Of the 109 patients, 40 patients required surgery, and 69 patients were managed conservatively. Analysis showed that the Hinchey classification (p<0.001) was the strongest predictor of treatment modality. Conclusions: As the incidence of diverticulitis has increased in recent decades, so too has the frequency with which elective surgical procedures are performed as treatment. While these procedures are vital components in the management of diverticulitis, the majority of research comparing conservative versus surgical treatments has been done in patients over 50 years old. Although diverticulitis has been classically thought of as a disease of the elderly, it has become more prevalent in younger populations due to the rise of obesity and lifestyle modification in the under-40 population. Although the prevalence of treatment and diagnosis of acute diverticulitis in younger patients has risen, there is a paucity of data surrounding treatment protocols for diverticulitis in association with patient symptoms for patients under the age of 40 years old. Our study has found that there is a higher incidence of complications in diverticulitis in patients under the age of 40. Additionally, when considering the pattern of complication presentation in younger patients with complicated diverticulitis, surgical intervention might not be appropriate. The current treatment algorithm relates diverticulitis complications with surgical interventions. However, our data suggest that patients under the age of 40 presenting with abscesses or strictures may not need surgical intervention. This information could be particularly helpful in guiding physicians and younger patients in selecting the best choice of care and minimizing complications. Additionally, further research should help guide treatment protocol in this specific population of patients, as there is a lack of established guidelines pertaining to diverticulitis surrounding younger patients.

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The Effects of Diverticulum Localization and Hinchey Classification on Recurrence and Complications in Acute Colonic Diverticulitis

Cited by 5 publications

References 15 publications

Management of Acute Uncomplicated Diverticulitis: Inpatient or Outpatient

Management of Acute Uncomplicated Diverticulitis: Inpatient or Outpatient

The impact of overweight on diverticular disease: a cross-sectional multicentre study

Diverticulitis in the Under-40 Population

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