Sigmoid diverticulitis in 2011: many questions; few answers.
Colorectal Dis
; 14(8): e439-46, 2012 Aug.
Article
in En
| MEDLINE
| ID: mdl-22404743
ABSTRACT
AIM:
Patients were studied after a first episode of acute left-colonic diverticulitis for the initial and later evolution of the disease with the aim of defining evidence-based indications for elective surgery.METHOD:
Relevant data from prospective studies were retrieved from a MEDLINE search of English language articles.RESULTS:
Young male patients (≤ 50 years of age) had a higher risk of CT-graded severe diverticulitis. After medical treatment of the first episode, the incidence of complications was highest for young patients with CT-graded severe diverticulitis and lowest for older patients with CT-graded moderate diverticulitis. Recurrence in the form of diffuse peritonitis was rare. CT grading of initial diverticulitis seemed to be a predictor of recurrence, whereas the role of age was less clear. A family history of diverticulitis might be predictive of recurrence.CONCLUSION:
CT grading of acute diverticulitis helps to predict poor outcome after medical treatment of a first episode. Elective surgical resection should be proposed to patients with residual symptoms who do not respond to conservative treatment. Additional research is needed to clarify the role of a genetic predisposition in the development of diverticulitis in young adults.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Sigmoid Diseases
/
Tomography, X-Ray Computed
/
Diverticulitis, Colonic
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Colorectal Dis
Journal subject:
GASTROENTEROLOGIA
Year:
2012
Document type:
Article
Affiliation country:
Suiza