Little is known about the epidemiology of diverticulitis in Japan. Additional information is needed about its clinical characteristics and the factors associated with complications of diverticulitis.
This study was designed to determine the clinical characteristics of diverticulitis and factors associated with its complications in Japanese patients.
This was a retrospective, multicenter, large-scale, cross-sectional study.
All of the consecutive patients in 21 Japanese hospitals with a final diagnosis of acute colonic diverticulitis were included in this study.
A total of 1112 patients, including 658 men and 454 women, with a mean age of 54.8 years, who were diagnosed by CT and/or ultrasonography between January 2006 and May 2011, were included in this study.
Data on medical history, investigations, treatments, and prognosis were collected using a standard form to create a dedicated database.
Clarification of the clinical characteristics of Japanese patients with acute diverticulitis was the main outcome measured.
Diverticulitis was detected mainly in men and women aged 40 to 60 years. Although diverticulitis more frequently affected the right colon (70.1%), diverticulitis of the left colon was significantly more frequent (61.0%) in elderly patients. Of the 1112 patients with diverticulitis, 179 (16.1%) developed complications, including abscess formation, perforation, stenosis, and/or fistula, some of which required surgical treatment, such as drainage or colonic resection. The duration of hospitalization (24.1 ± 19.5 days) and mortality rate (2.8%) were significantly higher in patients with versus without complications. Factors associated with complications were fever (>38.5°C), involvement of the left colon, higher age, and delayed diagnosis.
Limitations included the nonconsideration of diverticulitis treatment, the effect of dietary fiber, and the retrospective design of the study.
Complications were more frequent in elderly men with left-sided diverticulitis, although diverticulitis was more common in middle-aged people and on the right side of the colon. Factors associated with complications were fever, site of involvement, older age, and longer time until diagnosis.
1 Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan
2 Department of General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan
3 Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
4 Department of Gastroenterology, Hamamatsu Medical Center, Hamamatsu, Japan
5 Division of Gastroenterology, Fujieda Municipal General Hospital, Fujieda, Japan
6 Medical Examination Center of Chubu Medical Association, Chatan-cho, Japan
7 Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
Financial Disclosure: None reported.
Correspondence: Noriaki Manabe, M.D., Ph.D., Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan. E-mail: firstname.lastname@example.org