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Scand J Gastroenterol ; 55(4): 454-459, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32202966

RESUMO

Purpose: The purpose of this study was to evaluate the disease pattern and treatment of diverticular abscesses.Methods: Patients treated for diverticulitis (K57) in Västmanland, Sweden were identified for this retrospective population-based study between January 2010 and December 2014. Patients with diverticular abscesses were included. The clinical and radiological data were extracted, and the computed tomography scans were reevaluated.Results: Of the 75 patients (45 women) with a median age of 62 years (range: 23-88 years), abscesses were localized pericolic in 42 patients (59%) and in the pelvis in 33 patients (41%). The median abscess size was 4.8 cm (range: 1.1-11.0 cm). Six patients (8%) required urgent surgical intervention during the index admission. The median follow-up time was 58 months (range: 0-95 months). During follow-up, 40 patients (58%) had disease recurrence and 35 of these patients (88%) presented with complicated diverticulitis. The median time until re-admission was 2 months (range: 3 days-94 months). Patients with pelvic abscesses developed fistulas more frequently, 3 versus 11 patients (p = .003). Twenty-three percent of patients with pericolic abscesses required surgery compared with 40% of patients with pelvic abscesses (p = .09). No patients had a recurrence of abscesses after a colonic resection.Conclusion: The majority of patients with diverticular abscesses had recurrences with repeated admissions regardless of abscess location. An unexpectedly high proportion of patients required surgical intervention during the follow-up period. A liberal approach regarding elective surgery for patients with recurrent diverticulitis abscesses who tolerate surgery seems justified.


Assuntos
Abscesso Abdominal/terapia , Doenças Diverticulares/complicações , Abscesso Abdominal/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Colectomia/efeitos adversos , Colectomia/métodos , Tratamento Conservador/efeitos adversos , Tratamento Conservador/métodos , Doenças Diverticulares/patologia , Doenças Diverticulares/terapia , Drenagem/efeitos adversos , Drenagem/métodos , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva , Estudos Retrospectivos , Suécia , Tomografia Computadorizada por Raios X , Adulto Jovem
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