title: Detection of endoscopic and histological inflammation after an attack of colonic diverticulitis is associated with higher diverticulitis recurrence.
abstract: OBJECTIVE
  Colonic diverticulitis shows a high recurrence rate, but the factors associated with such recurrence are still unknown. The aim of our study was to investigate the role of endoscopic and histological inflammation as predictors for the recurrence of diverticulitis.
  
  
  METHODS
  One hundred and thirty patients suffering from Acute Uncomplicated Diverticulitis (AUD) (81 males, 49 females, mean age 64.71 years, range 40-85) were prospectively assessed. All patients had AUD confirmed by computerized tomography (CT) and endoscopy. Clinical, endoscopic and histological follow-up was performed after 6, 12 and thereafter 24 months after diagnosis of AUD.
  
  
  RESULTS
  Sixteen patients were lost to follow-up. Diverticulitis recurred in 18 patients (13.84%): 15 (13.15%) patients showed recurrence of AUD, whilst 3 (2.63%) showed recurrence of complicated diverticulitis. At the end of the follow-up period, endoscopic inflammation was still detected in 31 (27.67%) patients, and active histological inflammation in 41 patients (36.6 %). Only detection of endoscopic and of histological inflammation during the follow-up was a predictor of diverticulitis recurrence (Log rank test, p = 0.0004).
  
  
  CONCLUSIONS
  Detection of endoscopic and histological inflammation after attack of AUD was identified as a predictor of diverticulitis recurrence.
authors.affiliation: Gastroenterology Service, ASL BAT, Via Torino 49, 76123 Andria, BT, Italy. antotursi@tiscali.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Tursi
authors.forename: Walter
authors.initials: W
authors.lastname: Elisei
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Giorgetti
authors.forename: Cosimo Damiano
authors.initials: CD
authors.lastname: Inchingolo
authors.forename: Rosanna
authors.initials: R
authors.lastname: Nenna
authors.forename: Marcello
authors.initials: M
authors.lastname: Picchio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Brandimarte
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003106:Colon / Q000473:pathology; D003113:Colonoscopy; D004239:Diverticulitis, Colonic / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed