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The natural history diverticular disease: is there a role for elective colectomy?
J R Coll Surg Edinb. 2002 Apr; 47(2):481-2, 484.JR

Abstract

BACKGROUND

The natural history of colonic diverticular disease is unclear leading to a debate on the value of elective colectomy in preventing complications of the disease.

AIM

To assess whether the complications of diverticular disease requiring emergency surgery are related to previous episodes of diverticulitis and whether elective colectomy might prevent such complications.

MATERIALS AND METHODS

A retrospective study was done on all patients admitted with complicated diverticular disease in two adjacent district general hospitals between 1995 and 2000. Information was collected on the details of management of the complications and past history of the investigations and treatment for diverticular disease in these patients.

RESULTS

A total of 108 patients were admitted with complicated diverticular disease. Ninety eight (91%) patients were admitted as an emergency for perforated diverticular disease and rectal bleeding. Ten patients were urgent admissions for fistulae and diverticular phlegmons. Ninety eight patients underwent a Hartmann's operation, two had a subtotal colectomy and 4 patients had a sigmoid colectomy. Thirty four (31.4%) patients died in hospital post-operatively. Of the 108 patients, only 28 (26%) patients were known to have diverticular disease previously. Only three (2.7%) patients had had an episode of acute diverticulitis before they presented with further complications.

CONCLUSIONS

Complications of diverticular disease occur de novo in the majority of patients who have no previous history of the disease. Further studies are needed to identify risk factors for complicated diverticular disease before adopting a policy of elective interval colectomy.

Authors+Show Affiliations

Prince Charles Hospital, Merthyr Tydfil, Mid Glamorgan.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12018691

Citation

Somasekar, K, et al. "The Natural History Diverticular Disease: Is There a Role for Elective Colectomy?" Journal of the Royal College of Surgeons of Edinburgh, vol. 47, no. 2, 2002, pp. 481-2, 484.
Somasekar K, Foster ME, Haray PN. The natural history diverticular disease: is there a role for elective colectomy? J R Coll Surg Edinb. 2002;47(2):481-2, 484.
Somasekar, K., Foster, M. E., & Haray, P. N. (2002). The natural history diverticular disease: is there a role for elective colectomy? Journal of the Royal College of Surgeons of Edinburgh, 47(2), 481-2, 484.
Somasekar K, Foster ME, Haray PN. The Natural History Diverticular Disease: Is There a Role for Elective Colectomy. J R Coll Surg Edinb. 2002;47(2):481-2, 484. PubMed PMID: 12018691.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The natural history diverticular disease: is there a role for elective colectomy? AU - Somasekar,K, AU - Foster,M E, AU - Haray,P N, PY - 2002/5/23/pubmed PY - 2002/6/19/medline PY - 2002/5/23/entrez SP - 481-2, 484 JF - Journal of the Royal College of Surgeons of Edinburgh JO - J R Coll Surg Edinb VL - 47 IS - 2 N2 - BACKGROUND: The natural history of colonic diverticular disease is unclear leading to a debate on the value of elective colectomy in preventing complications of the disease. AIM: To assess whether the complications of diverticular disease requiring emergency surgery are related to previous episodes of diverticulitis and whether elective colectomy might prevent such complications. MATERIALS AND METHODS: A retrospective study was done on all patients admitted with complicated diverticular disease in two adjacent district general hospitals between 1995 and 2000. Information was collected on the details of management of the complications and past history of the investigations and treatment for diverticular disease in these patients. RESULTS: A total of 108 patients were admitted with complicated diverticular disease. Ninety eight (91%) patients were admitted as an emergency for perforated diverticular disease and rectal bleeding. Ten patients were urgent admissions for fistulae and diverticular phlegmons. Ninety eight patients underwent a Hartmann's operation, two had a subtotal colectomy and 4 patients had a sigmoid colectomy. Thirty four (31.4%) patients died in hospital post-operatively. Of the 108 patients, only 28 (26%) patients were known to have diverticular disease previously. Only three (2.7%) patients had had an episode of acute diverticulitis before they presented with further complications. CONCLUSIONS: Complications of diverticular disease occur de novo in the majority of patients who have no previous history of the disease. Further studies are needed to identify risk factors for complicated diverticular disease before adopting a policy of elective interval colectomy. SN - 0035-8835 UR - https://www.unboundmedicine.com/medline/citation/12018691/The_natural_history_diverticular_disease:_is_there_a_role_for_elective_colectomy L2 - https://www.diseaseinfosearch.org/result/2310 DB - PRIME DP - Unbound Medicine ER -