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 22 April 2018

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News

Predicting further complications from diverticular disease

Only a minority of patients with perforation, fistula, and bleeding have previous episodes of diverticulitis, and acute diverticulitis is not a good predictor of further complications from diverticular disease, reports this month's Colorectal Diseases.

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Diverticular disease is a common condition with high morbidity and mortality related to its complications.

Dr Salem and colleagues assessed the predictive role of acute diverticulitis in further complications from diverticular disease.

The investigative team undertook a prospective assessment of all patients with complicated diverticular disease over a 1-year period in a large teaching hospital.

All patients had documented evidence of their diagnosis by radiological, endoscopic or histopathological techniques when feasible.

The investigators identified 77 patients with complicated diverticular disease.

There were 53 females and 24 males with a median age of 74 years.

The team noted that acute diverticulitis occurred in 37 patients, fistula in 12, perforation in 8, bleeding in 7, abscess in 7 and stricture in 6.

Only 3 of 37 patients with acute diverticulitis had 2 or more admissions
Colorectal Diseases

Only 8 patients had 2 or more previous documented episodes of diverticulitis.

The team reported that 25 underwent surgery, 3 died, and 5 had a complication.

The investigators observed that 3 of 37 patients with acute diverticulitis had 2 or more admissions but none underwent surgery or developed further complications.

Computed tomography was performed during acute admission in 14 out of 37 patients with acute diverticulitis.

The majority of patients with fistula, perforation, bleeding, and abscess had no previous episode of diverticulitis.

The investigators noted that most patients with stricture had previous documented episodes.

Dr Salem's team concluded, “In our patient population acute diverticulitis is not a good predictor of the development of further complications from diverticular disease.”

“Only a minority of patients with perforation, fistula, abscess and bleeding had previous documented episodes of diverticulitis.”

Col Dis 2006: 8(3): 173
28 February 2006

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