title: A clinical and radiological comparison of sigmoid diverticulitis episodes 1 and 2.
abstract: OBJECTIVE
  After an initial uncomplicated attack, sigmoid diverticulitis may recur, but the morphological characteristics of recurrent diverticulitis have not been investigated. We compared the clinical and radiological severity, the respective location and clinical outcome of the first two episodes of sigmoid diverticulitis.
  
  
  METHODS
  We reviewed the charts of 60 patients [median age 61 (range 31-90) years] who were admitted initially for a first episode of uncomplicated left colonic diverticulitis, and who were eventually readmitted for a second episode, both being documented by abdominal computed tomography (CT) scan.
  
  
  RESULTS
  The median delay between the two episodes was 19 (3-97) months. Six (10%) patients developed a second complicated episode of diverticulitis [Hinchey II (n = 2), CT-guided percutaneous drainage; Hinchey III (n = 3), emergency Hartmann's operation; colovesical fistula (n = 1), elective sigmoid resection]. Fifty-four (90%) patients were admitted for a second episode of uncomplicated diverticulitis. In this group, the duration of hospital stay [11 (4-22) vs 10 (1-39) days, P = 0.28], serum levels of C-reactive protein [131 (31-350) vs 112 (22-333) mm, P = 0.62] and CT scan-based severity score [3 (1-6) vs 3 (0-7) points, P = 0.07] were similar between the two episodes. In 19 out of 54 (35%) patients with simple recurrent diverticulitis, although disease severity was similar, the disease topography differed and recurrence involved another segment of the left colon.
  
  
  CONCLUSIONS
  The majority of patients who develop recurrence do so in a similar mode and location. However, 10% develop complicated diverticulitis and in 35% of patients recurrent diverticulitis occurs at a different location.
authors.affiliation: Department of Surgery Radiology, Geneva University Hospital and Medical School, Genève, Switzerland. pascal.gervaz@hcuge.ch
authors.forename: P
authors.initials: P
authors.lastname: Gervaz
authors.forename: A
authors.initials: A
authors.lastname: Platon
authors.forename: L
authors.initials: L
authors.lastname: Widmer
authors.forename: P
authors.initials: P
authors.lastname: Ambrosetti
authors.forename: P-A
authors.initials: PA
authors.lastname: Poletti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D004239:Diverticulitis, Colonic / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012810:Sigmoid Diseases / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein