Acute colonic diverticulitis in the young.
BACKGROUND
Colonic diverticulitis in the young has been considered to have a virulent course, high morbidity, and high operative rate. As a result, elective resection of the involved colonic segment after the first clinical episode has been the usual practice.


OBJECTIVE
This study presents our experience with acute diverticulitis in the young.


METHODS
In the last nine years, 63 patients younger than 45 years were treated for acute diverticulitis at our institution. A retrospective review was performed to determine the clinical course and outcome of these patients.


RESULTS
Clinical presentations, radiographic tests, operative findings, and pathology results revealed that 57 patients had a pericolonic contained disease (Hinchey State I). Two patients had a large pelvic abscess (Hinchey Stage II), and four patients had a diffuse peritonitis (Hinchey Stage III). Forty-one patients (65 percent) were successfully treated medically with antibiotics and bowel rest. Of 22 patients (35 percent) who underwent emergent operations, 12 patients' diseases had been erroneously diagnosed preoperatively (9 "appendicitis").


CONCLUSIONS
Diverticulitis at a young age does not have a specific aggressive nature. Although, it is associated with a high rate of emergency operations, many of these are performed for a mistaken diagnosis. The recommendation for routine elective resection following the first episode of diverticulitis should be reassessed.
Spivak
H
H
Department of Surgery, Beth Israel Medical Center, New York, New York, USA.
Weinrauch
S
S
Harvey
J C
JC
Surick
B
B
Ferstenberg
H
H
Friedman
I
I
D000208:Acute Disease; D000328:Adult; D001064:Appendicitis / Q000175:diagnosis; D018450:Disease Progression; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies