Non-operative management of perforated diverticulitis with extraluminal or free air - a retrospective single center cohort study.
Scand J Gastroenterol
; 53(10-11): 1298-1303, 2018.
Article
em En
| MEDLINE
| ID: mdl-30353758
ABSTRACT
OBJECTIVES:
The aim of this study was to describe patient characteristics and results of non-operative management for patients presenting with computed tomography (CT) verified perforated diverticulitis with extraluminal or free air.METHODS:
All patients treated for diverticulitis (ICD-10 K-57) during 2010-2014 were identified and medical records were reviewed. Re-evaluations of CT examinations for all patients with complicated disease according to medical records were performed. All patients diagnosed with perforated diverticulitis and extraluminal or free air on re-evaluation were included and characteristics of patients having immediate surgery and those whom non-operative management was attempted are described.RESULTS:
Of 141 patients with perforated diverticulitis according to medical records, 136 were confirmed on CT re-evaluation. Emergency surgical intervention within 24 h of admission was performed in 29 (21%) patients. Non-operative management with iv antibiotics was attempted for 107 patients and was successful in 101 (94%). The 30-day mortality rate was 2%. The presence of a simultaneous abscess was higher for patients with failure of non-operative management compared with those that were successfully managed non-operatively (67% compared to 17%, p = .013). Eleven out of thirty-two patients (34%) with free air were successfully managed conservatively. Patients that were operated within 24 h from admission were more commonly on immunosuppressive therapy, had more commonly free intraperitoneal air and free fluid in the peritoneal cavity.CONCLUSIONS:
Non-operative management is successful in the majority of patients with CT-verified perforated diverticulitis with extraluminal air, and also in one-third of those with free air in the peritoneal cavity.Palavras-chave
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Drenagem
/
Doença Diverticular do Colo
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Perfuração Intestinal
/
Antibacterianos
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Scand J Gastroenterol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Suécia