Presentation, management and outcome of acute sigmoid diverticulitis requiring hospitalization.
OBJECTIVE
This study was conducted to assess the presentation, management, and outcomes of patients with acute sigmoid diverticulitis requiring hospitalization.


METHODS
From 1986 to 2005, the medical records of 265 patients treated for acute sigmoid diverticulitis requiring hospitalization were retrospectively analyzed. Data were collected with regard to patient's demographics, clinical characteristics, presentations of acute diverticulitis, treatment, morbidity, and mortality.


RESULTS
Only 47 patients (17.7%) had a previous diverticulitis episode. Of the 265 patients, 166 (62.6%) were managed without operation, and 99 (37.4%) underwent surgery. Overall and major morbidity in the whole series were 30.2 (80/265) and 15.5% (40/265), respectively; whereas among the patients with surgical management, were 72.7 (72/99), and 35.3% (35/99), respectively. Overall and postoperative mortality rates were 2.6 (7/265) and 6.1% (6/99), respectively. Older age, steroid use, perforation, and co-morbidities were significantly associated with unfavorable outcomes.


CONCLUSIONS
It was concluded that surgery for acute sigmoid diverticulitis requiring hospitalization carries important morbidity and mortality. To achieve improvements in outcome, a selective therapeutic approach should be considered, choosing the best surgical procedure for each complication of diverticular disease.
Alvarez
Jose A
JA
Service of General Surgery, Hospital San Agustín, Avilés, Spain.
Baldonedo
Ricardo F
RF
Bear
Isabel G
IG
Otero
Jorge
J
Pire
Gerardo
G
Alvarez
Paloma
P
Jorge
Jose I
JI
D018784:Abdominal Abscess / Q000209:etiology; D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002481:Cellulitis / Q000209:etiology; D015897:Comorbidity; D004239:Diverticulitis, Colonic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D004380:Duodenal Obstruction / Q000209:etiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000150:complications / Q000601:surgery / Q000628:therapy*