Do Appendicitis and Diverticulitis Share a Common Pathological Link?
OBJECTIVE
The aim of this study was to determine whether there is an association between appendicitis and diverticulitis.


METHODS
This study is a retrospective cohort analysis.


METHODS
This study was conducted in a subspecialty practice at a tertiary care facility.


METHODS
We examined the rate of appendectomy among 4 cohorts of patients: 1) patients with incidentally identified diverticulosis on screening colonoscopy, 2) inpatients with medically treated diverticulitis, 3) patients who underwent left-sided colectomy for diverticulitis, and 4) patients who underwent colectomy for left-sided colorectal cancer.


METHODS
There were no interventions.


METHODS
The primary outcome measured was the appendectomy rate.


RESULTS
We studied a total of 928 patients in this study. There were no differences in the patient characteristics of smoking status, nonsteroidal use, or history of irritable bowel syndrome across the 4 study groups. Patients with surgically treated diverticulitis had significantly more episodes of diverticulitis (2.8 ± 1.9) than the medically treated group (1.4 ± 0.8) (p < 0.0001). The rate of appendectomy was 8.2% for the diverticulosis control group, 13.5% in the cancer group, 23.5% in the medically treated diverticulitis group, and 24.5% in the surgically treated diverticulitis group (p < 0.0001). After adjusting for demographics and other clinical risk factors, patients with diverticulitis had 2.8 times higher odds of previous appendectomy (p < 0.001) than the control groups.


CONCLUSIONS
The retrospective study design is associated with selection, documentation, and recall bias.


CONCLUSIONS
Our data reveal significantly higher appendectomy rates in patients with a diagnosis of diverticulitis, medically or surgically managed, in comparison with patients with incidentally identified diverticulosis. Therefore, we propose that appendicitis and diverticulitis share similar risk factors and potentially a common pathological link.
Department of Colon and Rectal Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts.
Jesslynne
J
Harvey
Patricia L
PL
Roberts
David J
DJ
Schoetz
Jason F
JF
Hall
Thomas E
TE
Read
Peter W
PW
Marcello
Todd D
TD
Francone
Rocco
R
Ricciardi
D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D003082:Colectomy; D003113:Colonoscopy; D004239:Diverticulitis, Colonic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D043963:Diverticulosis, Colonic / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D033162:Incidental Findings; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed