Virulent diverticular disease in young obese men

Schauer, Philip R.; Ramos, Raul; Ghiatas, Abraham A.; Sirinek, Kenneth R.

doi:10.1016/s0002-9610(05)81177-8

Cited by 189 publications

(112 citation statements)

References 23 publications

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“…This policy is not often followed in our hospital and we incline towards conservative management in the presence of patients’ medical co-morbidities. The benefit of an elective resection for recurrent symptoms should be weighed against the risks of an emergency surgery in old and fragile patients as well as those with concurrent disease [2, 5, 14]. In this study, emergency operations were associated with significant morbidity, mortality and prolonged hospital stay implying the consequences of an emergency surgery in a high-risk population of patients.…”

Section: Discussionmentioning

confidence: 89%

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: 89%

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

2007

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“…An association between obesity and diverticulitis has been demonstrated in a number of retrospective and case-control studies (11)(12)(13)(14)(15). In a study using BMI, the incidence of obesity was higher in patients with recurrent diverticulitis or diverticulitis-associated perforation or abscess than in patients with diverticulosis or a single episode of diverticulitis (11).…”

Section: Body Mass Indexmentioning

confidence: 98%

“…There were no significant differences between the three groups with respect to TG (Figure 3). (21), and obesity has been shown to play a role in the increasing incidence of colonic diverticulitis (11)(12)(13)(14)(15)(16)22). However, whether or not colonic diverticulosis is related to obesity remains a matter of controversy because of the limited number of relevant studies.…”

Section: Serum Lipid Profilesmentioning

confidence: 99%

“…In addition to these risk factors, other researchers have reported that physical inactivity, decreased intake of dietary fiber, genetic factors, and use of aspirin or nonsteroidal anti-inflammatory drugs may be risk factors for diverticulosis or complicated diverticular diseases (6)(7)(8)(9)(10). It has also been reported that obesity increases the risk of complicated diverticular diseases, such as diverticulitis or diverticular bleeding (7,(11)(12)(13)(14)(15)(16). However, Sorser et al (17) found no relationship between obesity and diverticulitis.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between colonic diverticulosis and abdominal visceral and subcutaneous fat accumulation measured by abdominal CT scan

Lee

Ahn

Lee

et al. 2014

Turk J Gastroenterol

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Background/Aims: Besides age, risk factors for colonic diverticular disease include dietary meat intake and Western lifestyles, which are also risk factors for obesity. However, the association between obesity and colonic diverticular disease, including diverticulosis and diverticulitis, is not well established. The aim of this study was to investigate the relationship between colonic diverticulosis and obesity using abdominal fat quantified by abdominal CT scan and lipid profiles, as well as body mass index (BMI). Materials and Methods: In this study based on a retrospective case note review, we enrolled 133 subjects (control group (n=55), diverticulosis group (31), and diverticulitis group (47)). Abdominal fat areas (total abdominal fat, visceral fat, subcutaneous fat) were quantified by abdominal CT scan. Serum lipid profiles and BMI were checked. Statistical analysis was performed by independent t-tests, with significance set at p<0.05. Results: In the diverticulosis group, total abdominal fat area, visceral fat area, and abdominal subcutaneous fat area were all larger than those of the control and diverticulitis groups. In the diverticulitis group, total cholesterol, high density lipoprotein (HDL), low-density lipoprotein (LDL), and BMI were lower than in the control and diverticulosis groups. There were no significant differences between the three groups in visceral-to-subcutaneous abdominal fat ratios and serum triglyceride levels. Conclusion: In conclusion, obesity may predispose one to occurrence of colonic diverticulosis. Abdominal fat measurement by CT scan may be a good method of assessing risk of colonic diverticular disease.

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“…Die kumulative Wahrscheinlichkeit über 10.8 Jahre eine Divertikulitis zu entwickeln betrug 4.3%, sie lag für 40-jährige mit 11% am höchsten und nahm mit steigendem Lebensalter mit jeder zusätzlichen Dekade um 24% ab [73]. Der von einigen Autoren beschriebene aggressivere Verlauf der Divertikelkrankheit bei jüngeren Patienten [74,75] scheint sich in neueren Arbeiten nicht zu bestätigen [76][77][78]. Die Daten zu einer Geschlechterpräferenz bei der Divertikulose sind inhomogen [67,69].…”

Section: Statement 26unclassified

Failure to Use Ultrasound Is a Glaring Shortcoming

Läng¹

2018

Deutsches Ärzteblatt International

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Virulent diverticular disease in young obese men

Cited by 189 publications

References 23 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

The relationship between colonic diverticulosis and abdominal visceral and subcutaneous fat accumulation measured by abdominal CT scan

Failure to Use Ultrasound Is a Glaring Shortcoming

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