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Emergency surgery for complicated acute diverticulitis.
Colorectal Dis 2009; 11(2):198-202CD

Abstract

AIM

Antecedent attacks of diverticulitis are thought to increase the risk of complicated diverticulitis, and unless elective surgery is performed, a high proportion of patients with recurrent symptoms will require emergency operations for complicated diverticulitis with its associated morbidity. In this multicentre study, we aim to assess impact of previous attacks of diverticulitis on patients requiring an emergency surgical intervention.

METHOD

All patients operated on as an emergency for complicated diverticulitis were retrospectively analysed. Patients were separated into two groups: group A included patients without previous history of diverticular disease, and group B those with previous attacks of diverticulitis.

RESULTS

A total of 96 patients were included in the study. Group A included 68 (70.8%) patients, and group B 28 (29.2%) patients. Generalized peritonitis was the reason for operation in 50 (73.5%) patients in-group A and only four (14%) patients in group B. Perforated diverticulitis occurred more often in group A, whereas pericolonic abscess and phlegmon formation occurred more commonly in group B. Resection was performed in all patients in group B; 50% had a Hartmann's procedure, and the other 50% patients had primary anastomosis. Hartmann's procedure was performed in 52 patients (76.5%) in group A, and 8 patients (11.7%) had resection and primary anastomosis. No difference in postoperative complications was identified between the groups.

CONCLUSION

Multiple attacks of diverticulitis are not associated with an increased risk of complicated diverticulitis. Recurrent episodes of diverticulitis are not associated with a less favourable outcome or an increased risk of fatality if complications ensue.

Authors+Show Affiliations

Department of Surgery A, Meir Hospital, Sapir Medical Center, and the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

18462249

Citation

Issa, N, et al. "Emergency Surgery for Complicated Acute Diverticulitis." Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, vol. 11, no. 2, 2009, pp. 198-202.
Issa N, Dreznik Z, Dueck DS, et al. Emergency surgery for complicated acute diverticulitis. Colorectal Dis. 2009;11(2):198-202.
Issa, N., Dreznik, Z., Dueck, D. S., Arish, A., Ram, E., Kraus, M., ... Neufeld, D. (2009). Emergency surgery for complicated acute diverticulitis. Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 11(2), pp. 198-202. doi:10.1111/j.1463-1318.2008.01546.x.
Issa N, et al. Emergency Surgery for Complicated Acute Diverticulitis. Colorectal Dis. 2009;11(2):198-202. PubMed PMID: 18462249.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergency surgery for complicated acute diverticulitis. AU - Issa,N, AU - Dreznik,Z, AU - Dueck,D S, AU - Arish,A, AU - Ram,E, AU - Kraus,M, AU - Gutman,M, AU - Neufeld,D, Y1 - 2008/05/03/ PY - 2008/5/9/pubmed PY - 2009/4/25/medline PY - 2008/5/9/entrez SP - 198 EP - 202 JF - Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland JO - Colorectal Dis VL - 11 IS - 2 N2 - AIM: Antecedent attacks of diverticulitis are thought to increase the risk of complicated diverticulitis, and unless elective surgery is performed, a high proportion of patients with recurrent symptoms will require emergency operations for complicated diverticulitis with its associated morbidity. In this multicentre study, we aim to assess impact of previous attacks of diverticulitis on patients requiring an emergency surgical intervention. METHOD: All patients operated on as an emergency for complicated diverticulitis were retrospectively analysed. Patients were separated into two groups: group A included patients without previous history of diverticular disease, and group B those with previous attacks of diverticulitis. RESULTS: A total of 96 patients were included in the study. Group A included 68 (70.8%) patients, and group B 28 (29.2%) patients. Generalized peritonitis was the reason for operation in 50 (73.5%) patients in-group A and only four (14%) patients in group B. Perforated diverticulitis occurred more often in group A, whereas pericolonic abscess and phlegmon formation occurred more commonly in group B. Resection was performed in all patients in group B; 50% had a Hartmann's procedure, and the other 50% patients had primary anastomosis. Hartmann's procedure was performed in 52 patients (76.5%) in group A, and 8 patients (11.7%) had resection and primary anastomosis. No difference in postoperative complications was identified between the groups. CONCLUSION: Multiple attacks of diverticulitis are not associated with an increased risk of complicated diverticulitis. Recurrent episodes of diverticulitis are not associated with a less favourable outcome or an increased risk of fatality if complications ensue. SN - 1463-1318 UR - https://www.unboundmedicine.com/medline/citation/18462249/Emergency_surgery_for_complicated_acute_diverticulitis_ L2 - https://doi.org/10.1111/j.1463-1318.2008.01546.x DB - PRIME DP - Unbound Medicine ER -