Acute diverticulitis in younger patients: any rationale for a different approach?
OBJECTIVE
To compare the natural history and course of acute diverticulitis in a younger age group with an older population and to evaluate whether younger patients should be managed differently.


METHODS
This study was a retrospective review of 157 patients treated with acute diverticulitis between January 1, 2004 and December 31, 2007. Diverticulitis was stratified according to the Hinchey classification. Patients were divided into 2 populations: group A ≤ 50 years (n = 31); group B > 50 years (n = 126). Mean patient follow-up was 15 mo.


RESULTS
The median age was 60 years. A significantly higher proportion of patients in group B presented with complicated diverticulitis (36.5% vs 12.9%, P = 0.01). Recurrence was more frequent in group A (25.8% vs 11.1%, P = 0.03) and the mean time-to-recurrence was shorter (12 mo vs 28 mo, P = 0.26). The most severe recurrent episodes of acute diverticulitis were classified as Hinchey stage I and none of the patients required emergency surgery. In multivariate analysis, only age (P = 0.024) was identified as an independent prognostic factor for recurrence.


CONCLUSIONS
Based on the results of this study, the authors recommend that diverticulitis management should be based on the severity of the disease and not on the age of the patient.
Department of General Surgery, Hospital de São João, Al. Prof. Hernâni Monteiro, HSJ, 4200-319 Porto, Portugal. gilfaria@netcabo.pt
Gil R
GR
Faria
Ana B
AB
Almeida
Herculano
H
Moreira
João
J
Pinto-de-Sousa
Pedro
P
Correia-da-Silva
Amadeu P
AP
Pimenta
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004239:Diverticulitis, Colonic / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
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