A retrospective analysis of medical or surgical therapy in young patients with diverticulitis.
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.
Greenberg
A S
AS
Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Gal
R
R
Coben
R M
RM
Cohen
S
S
Dimarino
A J
AJ
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
D000900:Anti-Bacterial Agents