Faria GR, Almeida AB, Moreira H, Pinto-de-Sousa J, Correia-da-Silva P, Pimenta AP. Acute diverticulitis in younger patients: Any rationale for a different approach? World J Gastroenterol 2011; 17(2): 207-212 [PMID: 21245993 DOI: 10.3748/wjg.v17.i2.207]
Corresponding Author of This Article
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
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World J Gastroenterol. Jan 14, 2011; 17(2): 207-212 Published online Jan 14, 2011. doi: 10.3748/wjg.v17.i2.207
Acute diverticulitis in younger patients: Any rationale for a different approach?
Gil R Faria, Ana B Almeida, Herculano Moreira, João Pinto-de-Sousa, Pedro Correia-da-Silva, Amadeu P Pimenta
Gil R Faria, Ana B Almeida, Herculano Moreira, João Pinto-de-Sousa, Pedro Correia-da-Silva, Amadeu P Pimenta, Department of General Surgery, Hospital de São João, Al. Prof. Hernâni Monteiro, HSJ, 4200-319 Porto, Portugal
Gil R Faria, Herculano Moreira, João Pinto-de-Sousa, Amadeu P Pimenta, Faculty of Medicine of the University of Porto, Al. Prof. Hernâni Monteiro, HSJ 4200-319 Porto, Portugal
João Pinto-de-Sousa, Amadeu P Pimenta, Institute of Pathology and Molecular Immunology of the University of Porto - IPATIMUP - Rua Dr. Roberto Frias s/n , 4200-465 Porto, Portugal
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.
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
Telephone: +351-2-25512100 Fax: +351-2-24112916
Received: March 30, 2010 Revised: May 5, 2010 Accepted: May 12, 2010 Published online: January 14, 2011
Abstract
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 B > 50 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-to-recurrence was shorter (12 mo vs 28 mo, P = 0.26). The most severe recurrent episodes of acute diverticulitis were classified as Hinchey stage I and 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, the authors recommend that diverticulitis management should be based on the severity of the disease and not on the age of the patient.
