Emergency surgery for complicated acute diverticulitis.
OBJECTIVE
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.


METHODS
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.


CONCLUSIONS
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.
Issa
N
N
Department of Surgery A, Meir Hospital, Sapir Medical Center, and the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Dreznik
Z
Z
Dueck
D S
DS
Arish
A
A
Ram
E
E
Kraus
M
M
Gutman
M
M
Neufeld
D
D
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003082:Colectomy / Q000401:mortality; D004239:Diverticulitis, Colonic / Q000401:mortality / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006801:Humans; D015994:Incidence; D007416:Intestinal Perforation / Q000401:mortality / Q000601:surgery*; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence