title: Diverticular disease in younger patients--is it clinically more complicated and related to obesity?
abstract: OBJECTIVE
  The aims of this systematic review were to determine the presentations of diverticular disease in patients under 40 years of age and to assess whether obesity is an important factor.
  
  
  METHODS
  The PubMed and EMBASE databases and the Cochrane Library were searched to identify all original articles published between 1990 and 2011 on diverticular disease severity in obese patients (body mass index of ≥ 30 kg/m(2) ) under 40 years of age.
  
  
  RESULTS
  Twenty-three clinical case series (two of which were prospective) were identified plus two large aetiological population-based studies. These reported that young patients with diverticular disease were presenting more frequently, that diverticular disease in this age group was less likely to be complicated but that emergency operation rates were higher. The majority (63.1-96.5%) of patients under 40 years of age with diverticular disease were obese.
  
  
  CONCLUSIONS
  The studies suggest that in the young, obese patient with lower abdominal pain, diverticulitis and appendicitis are included in the differential diagnosis. CT and/or laparoscopy should be considered where the diagnosis is in doubt.
authors.affiliation: Department of General Surgery, Norfolk & Norwich University Hospital, Norwich, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Pilgrim
authors.forename: A R
authors.initials: AR
authors.lastname: Hart
authors.forename: C T M
authors.initials: CT
authors.lastname: Speakman
mesh_terms: D000367:Age Factors; D004238:Diverticulitis / Q000150:complications* / Q000601:surgery; D006801:Humans; D009765:Obesity / Q000150:complications*; D012720:Severity of Illness Index
keywords: Young; diverticular disease; diverticulitis; obese; obesity