title: A retrospective analysis of medical or surgical therapy in young patients with diverticulitis.
abstract: BACKGROUND
  Acute diverticulitis is increasingly being recognized in younger patients, but its management remains controversial.
  
  
  OBJECTIVE
  To compare long-term outcomes of young patients treated with surgery vs. medical therapy for their first episode of diverticulitis.
  
  
  METHODS
  A retrospective chart analysis at a university and an affiliated community hospital between 1991 and 2002 revealed 149 patients < or = 40 years of age with confirmed diverticulitis. Forty-nine patients (38 males, 11 females) were contacted at least 1 year after their first episode of diverticulitis. Outcomes were compared based on initial therapy--antibiotics or surgical resection. The groups were compared by outcomes, gender, age, white blood cell count, temperature and diet.
  
  
  RESULTS
  Three (15%) of 20 surgical patients (mean follow-up 6.89 years), and 16 (55%) of 29 medical patients had a recurrence of diverticulitis (mean follow-up 5.72 years; P = 0.01). The treatment groups did not differ in age, white blood cell count, or temperature.
  
  
  CONCLUSIONS
  (i) Surgical treatment is effective initial therapy but disease may recur in a minority of patients; (ii) medical treatment is less effective initial therapy, with recurrence in half of the patients; (iii) initial presentation is not a strong predictor of disease recurrence.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Greenberg
authors.forename: R
authors.initials: R
authors.lastname: Gal
authors.forename: R M
authors.initials: RM
authors.lastname: Coben
authors.forename: S
authors.initials: S
authors.lastname: Cohen
authors.forename: A J
authors.initials: AJ
authors.lastname: Dimarino
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004238:Diverticulitis / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents