title: Sigmoid diverticulitis in young patients--a more aggressive disease than in older patients?
abstract: BACKGROUND
  There is controversy over whether sigmoid diverticulitis (SD) is more aggressive with a higher risk of perforation in younger than in older patients. The aim of this study was to assess the clinical presentation and outcome of patients ≤40 and >40 years old with acute diverticulitis.
  
  
  METHODS
  Consecutive admissions of all patients with acute SD were prospectively recruited from January 1998 to June 2010.
  
  
  RESULTS
  A total of 1,019 patients were included: 513 (69 ≤40 years and 444 >40 years) presented with their first episode, while 506 (20 ≤40 years, 486 >40 years) had a prior history of SD. The percentage of patients with severe SD did not differ between the two age groups either for the first (covered perforation, 30.4% vs. 29.5%, p = 0.875; free perforation, 26.1% vs. 23.9%, p = 0.69) or for the recurrent episode (covered perforation, 15% vs. 8.2%, p = 0.287; free perforation, 5% vs. 4.1%, p = 0.846). Furthermore, the rate of emergency surgery did not differ between both age groups either for the first (26.1% vs. 23.9%, p = 0.690) or the recurrent episode (5% vs. 4.1%, p = 0.846). No differences in the rate of Hartmann's procedure (52.6% vs. 68.3%, p = 0.180) and failure of conservative treatment (3.4% vs. 4.9%, p = 0.607) were observed between younger and older patients.
  
  
  CONCLUSIONS
  Acute SD in younger patients is not more aggressive and has no higher risk of perforation or need for emergency surgery compared to older patients.
authors.affiliation: Department of General, Vascular and Thoracic Surgery, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
authors.forename: Jörg-Peter
authors.initials: JP
authors.lastname: Ritz
authors.forename: Kai S
authors.initials: KS
authors.lastname: Lehmann
authors.forename: Andrea
authors.initials: A
authors.lastname: Stroux
authors.forename: Heinz J
authors.initials: HJ
authors.lastname: Buhr
authors.forename: Christoph
authors.initials: C
authors.lastname: Holmer
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D004238:Diverticulitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012810:Sigmoid Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed