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Acute Diverticulitis: A Decade of Prospective Follow-up

Lahat, Adi MD*; Avidan, Benjamin MD*; Sakhnini, Emad MD*; Katz, Lior MD*; Fidder, Herma H. MD, PhD; Meir, Simon Bar MD*

Journal of Clinical Gastroenterology: May/June 2013 - Volume 47 - Issue 5 - p 415–419
doi: 10.1097/MCG.0b013e3182694dbb
ALIMENTARY TRACT: Original Articles
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Background: Acute diverticulitis (AD) is the most common complication of diverticular disease and affects 10% to 25% of patients. Data regarding the natural history of AD are lacking.

Goals: Our aim was to prospectively assess the occurrence of recurrent attacks, surgeries, and accompanying symptoms in patients who were hospitalized with AD.

Study: All patients hospitalized with first episode of AD between January 2000 and November 2006 were enrolled. Patients were followed up both during hospitalization and after discharge. Data regarding operations and complications were collected. Special attention was paid to patients younger than 45 years of age and compared with older patients.

Results: A total of 261 patients were identified—of them 103 were men. Thirty patients (11.5%) were 45 years old or younger. The mean follow-up period was 88±22 months (range, 52 to 184 mo). Younger patients experienced significantly more complications during hospitalization (37% vs. 12.5%, P=0.001) and underwent more often a sigmoidectomy in the follow-up period (42.3% vs. 18.3%, P=0.01). Older patients tended to be more often asymptomatic after discharge (P=0.053). The average time from index hospitalization to the sigmoidectomy was 18.17±23.35 months (range, 1 to 120 mo). The odds ratio for sigmoidectomy after complicated AD is 16.2 (95% confidence interval, 13.4 to 19.6). Age did not affect the risk for surgery.

Conclusions: Younger patients with AD experience more complications during hospitalization and undergo surgery after discharge more frequently. Complicated AD at index hospitalization is a risk factor for sigmoidectomy. Our data can help predict the outcome of patients suffering from AD and enable tailoring an individual treatment.

*Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel

Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

The authors declare that they have nothing to disclose.

Reprints: Adi Lahat, MD, Department of Gastroenterology, Chaim Sheba Medical Center, Ramat Gan, Tel Hashomer 52651, Israel (e-mail: zokadi@gmail.com).

Received February 23, 2012

Accepted July 6, 2012

© 2013 by Lippincott Williams & Wilkins