An exploratory analysis of the epidemiology and surgical management of perforated diverticular disease over a two-year period at a referral centre in the Caribbean.
OBJECTIVE
We present an exploratory analysis of data collected on perforated diverticular disease (PDD) in Barbados and suggest possible areas for further study.


METHODS
All cases of perforated diverticular disease treated at the Queen Elizabeth Hospital (QEH) Barbados, between January 1, 2005 and December 31, 2006 were reviewed. The patient's age, gender location of disease, Hinchey stage, operative procedure, rate of colostomy reversal, length of hospitalization, incidence of peri-operative morbidity and postoperative mortality were analysed using principal components analysis (PCA).


RESULTS
Fourteen cases of PDD were treated at the QEH during this period. Six (43%) of the patients had perforated right-sided diverticulitis (PRSD). In the PCA, Dimensions 1 and 2 were the two dimensions examined, as they both had Eigenvalues over 1. Dimension 1 can be taken as an indicator of the intensity of the disease. On dimension 2, length of hospitalization had the highest component loading (0.875). The mean hospital stay was 10.6 days in PRSD, 9.5 in left-sided perforations with primary anastomosis, and 16.2 days for those with a Hartmann's procedure. The overall peri-operative morbidity was 28% and there was no mortality in the series.


CONCLUSIONS
This preliminary study seems to show a relatively high incidence of PRSD in a predominantly Afro-Caribbean population. More research is needed to determine the exact aetiology of this disease. In our experience, primary anastomosis in carefully selected patients with either PRSD or perforated left-sided diverticulitis (PLSD) may result in shorter hospitalization.
Griffith
P S
PS
Department of Surgery, Queen Elizabeth Hospital, Bridgetown, Barbados. atunakken@yahoo.com
Powlett
C L
CL
Griffith
A D
AD
Markogiannakis
H
H
Priego
P
P
Jonnalagadda
R
R
Walrond
E R
ER
D044383:Black People; D017691:Caribbean Region / Q000453:epidemiology; D003082:Colectomy / Q000706:statistics & numerical data; D003125:Colostomy / Q000706:statistics & numerical data; D043963:Diverticulosis, Colonic / Q000453:epidemiology* / Q000208:ethnology / Q000601:surgery; D006801:Humans; D007081:Ileostomy / Q000706:statistics & numerical data; D015994:Incidence; D007416:Intestinal Perforation / Q000453:epidemiology* / Q000208:ethnology / Q000601:surgery; D025341:Principal Component Analysis; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies