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News

Medical comorbidities predict the need for colectomy for recurrent diverticulitis

Medical comorbidities predict the need for colectomy for complicated and recurrent diverticulitis, finds November’s issue of the American Journal of Surgery.

News image

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Dr Peter Yoo and colleagues from Connecticut, USA identified risk factors for recurrent or complicated diverticulitis requiring colectomy.

A total of 112 patients were admitted to the West Haven Veterans Affairs Medical Center with the diagnosis of colonic diverticular disease from 1998 to 2006.

A total of 23% of patients proceeded to laparoscopy
Annals of Surgery

Patients' records were assessed for demographics, past medical history, and physical and biochemical features of presentation.

Student t tests, analysis of variance, and chi-square analysis were used to compare binary and categoric data.

The medical records of 112 patients admitted to the West Haven Veterans Affairs hospital with the diagnosis of diverticulitis were analyzed retrospectively.

The team noted that a total of 97% were male, with a mean age of 63 years, and a significant smoking history greater than 30 pack-years was present in 71% of patients.

The research team found that 84% of patients presented with localized abdominal pain, and 70% had abdominal tenderness without peritoneal signs.

Computed tomography was performed in 86% of cases.

The researchers observed that a total of 23% of patients proceeded to laparoscopy.

Free perforation was the most common indication followed by a history of 2 or more antecedent attacks of diverticulitis.

Analysis of variance showed that serum albumin levels were significantly lower in the group undergoing colectomy compared with those who did not.

The need for colectomy owing to complicated or recurrent attacks correlated with glucocorticoid use, and a history of chronic obstructive pulmonary disease.

The team noted that the need for colostomy owing to complicated or recurrent attacks did not correlate with diabetes mellitus, collagen vascular disease, or inflammatory bowel disease.

Dr Yoo’s team comments, “The rules regarding the treatment of diverticulitis are evolving.”

“Comorbid conditions such as hypoalbuminemia, chronic obstructive pulmonary disease, and glucocorticoid use may predispose patients to recurrent or complicated attacks of diverticulitis requiring colectomy.”

“Stratification and reduction of risks may reduce the overall morbidity and mortality of diverticulitis.”

Am J Surg 2008: 196(5): 710-14


30 October 2008

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