Acute diverticulitis in younger patients：Any rationale for a different approach

AIM：To compare the natural history and course of acute diverticulitis in a younger age group with an older population and to evaluate whether younger patients should be managed differently. METHODS：This study was a retrospective review of 157 patients treated with acute diverticulitis between Januar...

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Published inWorld journal of gastroenterology : WJG Vol. 17; no. 2; pp. 207 - 212
Main Authors Faria, Gil R, Almeida, Ana B, Moreira, Herculano, Pinto-de-Sousa, João, Correia-da-Silva, Pedro, Pimenta, Amadeu P
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Co., Limited 14.01.2011
Subjects
Adult
Age Factors
Aged
Aged, 80 and over
Brief
Diverticulitis, Colonic - diagnosis
Diverticulitis, Colonic - epidemiology
Female
Follow-Up Studies
Humans
Inflammation
Male
Middle Aged
Multivariate Analysis
Recurrence
Retrospective Studies
Treatment Outcome
严重程度
原理
多变量分析
平均年龄
平均时间
年龄组
急性
患者
Recurrence
Severity
Acute diverticulitis
Surgical treatment
Age factors
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Summary:AIM：To compare the natural history and course of acute diverticulitis in a younger age group with an older population and to evaluate whether younger patients should be managed differently. METHODS：This study was a retrospective review of 157 patients treated with acute diverticulitis between January 1,2004 and December 31,2007.Diverticulitis was stratified according to the Hinchey classification. Patients were divided into 2 populations：group A≤ 50 years（n=31） ;group B50 years（n=126） .Mean patient follow-up was 15 mo. RESULTS：The median age was 60 years.A significantly higher proportion of patients in group B presented with complicated diverticulitis（36.5%vs 12.9%,P=0.01） .Recurrence was more frequent in group A（25.8%vs 11.1%,P=0.03） and the mean time-torecurrence was shorter（12 mo vs 28 mo,P=0.26） . The most severe recurrent episodes of acute diverticulitis were classified as Hinchey stageⅠand none of the patients required emergency surgery.In multivariate analysis,only age（P=0.024） was identified as an independent prognostic factor for recurrence. CONCLUSION：Based on the results of this study,we recommend that diverticulitis management should be based on the severity of the disease and not on the age of the patient.
Bibliography:Gil R Faria,Ana B Almeida,Herculano Moreira,Joo Pinto-de-Sousa,Pedro Correia-da-Silva,Amadeu P Pimenta Gil R Faria,Ana B Almeida,Herculano Moreira,Joo Pintode-Sousa,Pedro Correia-da-Silva,Amadeu P Pimenta,Department of General Surgery,Hospital de So Joo,Al.Prof. Hernani Monteiro,HSJ,4200-319 Porto,Portugal Gil R Faria,Herculano Moreira,Joo Pinto-de-Sousa,Amadeu P Pimenta,Faculty of Medicine of the University of Porto,Al.Prof.Hernani Monteiro,HSJ 4200-319 Porto,Portugal Joo Pinto-de-Sousa,Amadeu P Pimenta,Institute of Pathology and Molecular Immunology of the University of PortoIPATIMUP-Rua Dr.Roberto Frias s/n,4200-465 Porto,Portugal
AIM：To compare the natural history and course of acute diverticulitis in a younger age group with an older population and to evaluate whether younger patients should be managed differently. METHODS：This study was a retrospective review of 157 patients treated with acute diverticulitis between January 1,2004 and December 31,2007.Diverticulitis was stratified according to the Hinchey classification. Patients were divided into 2 populations：group A≤ 50 years（n=31） ;group B50 years（n=126） .Mean patient follow-up was 15 mo. RESULTS：The median age was 60 years.A significantly higher proportion of patients in group B presented with complicated diverticulitis（36.5%vs 12.9%,P=0.01） .Recurrence was more frequent in group A（25.8%vs 11.1%,P=0.03） and the mean time-torecurrence was shorter（12 mo vs 28 mo,P=0.26） . The most severe recurrent episodes of acute diverticulitis were classified as Hinchey stageⅠand none of the patients required emergency surgery.In multivariate analysis,only age（P=0.024） was identified as an independent prognostic factor for recurrence. CONCLUSION：Based on the results of this study,we recommend that diverticulitis management should be based on the severity of the disease and not on the age of the patient.
14-1219/R
Acute diverticulitis; Recurrence; Age factors; Severity; Surgical treatment
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Author contributions: Faria GR and Almeida AB collected the data; Faria GR and Pinto-de-Sousa J analyzed the results; Faria GR and Moreira H wrote the article; Moreira H and Correia-da-Silva P designed the study; Pinto-de-Sousa J and Pimenta AP reviewed the article.
Telephone: +351-2-25512100 Fax: +351-2-24112916
Correspondence to: Gil R Faria, MD, MSc, Department of General Surgery, Hospital de São João, Al. Prof. Hernâni Monteiro, HSJ, 4200-319 Porto, Portugal. gilfaria@netcabo.pt
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v17.i2.207