title: Diverticular disease is associated with benign intra-abdominal cystic disease.
abstract: BACKGROUND
  Diverticular disease (DD) and hepatic and renal cysts have been linked with defects in collagen and dysfunctional matrix metalloproteinases.
  
  
  METHODS
  Consecutive abdominal computed tomography scans between January-July 2015 were prospectively studied to determine a correlation between visceral cysts and DD. Patients with a sigmoid colectomy for pathology other than DD and scans in which DD and/or solid organs were not fully visualized were excluded. A subgroup analysis was performed on youthful DD patients (<55 years of age, n = 32) vs. older controls (>55, n = 213).
  
  
  RESULTS
  238 DD patients (50.8% male) and 369 controls (40.5% male, p = .02) were included. Incidence of visceral cystic disease in DD patients vs. controls was 71.4% vs. 22.5% (p < 0.00001). Renal cysts, present in 53.4% of the DD patients and 18.7% of the controls (p < .00001), were more common than hepatic cysts in both groups. Hepatic cyst prevalence was 8.8 vs. 2.4% (p = .0008). In the subgroup analysis, cystic disease was present in 56.2% of youthful DD patients vs. 29.1% of older controls (p = .004).
  
  
  CONCLUSIONS
  A significant association between cystic disease and DD was demonstrated overall and in subgroup analysis inclusive of youthful DD patients and older controls. These findings suggest a global defect in connective tissue integrity in DD patients.
authors.affiliation: a Department of Surgery , The Galway Clinic , Galway , Ireland.
authors.forename: Paula F
authors.initials: PF
authors.lastname: Wrafter
authors.affiliation: b Department of Surgery , University Hospital Galway , Galway , Ireland.
authors.forename: Tara M
authors.initials: TM
authors.lastname: Connelly
authors.affiliation: b Department of Surgery , University Hospital Galway , Galway , Ireland.
authors.forename: Jody S A
authors.initials: JS
authors.lastname: Khan
authors.affiliation: c Department of Radiology , The Galway Clinic , Galway , Ireland.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Lucey
authors.affiliation: d Division of Biostatistics Bioinformatics , Milton S. Medical Center, Penn State College of Medicine , Hershey , PA , USA.
authors.forename: Arthur
authors.initials: A
authors.lastname: Berg
authors.affiliation: e Division of Colon and Rectal Surgery , Milton S. Medical Center, Penn State College of Medicine , Hershey , PA , USA.
authors.forename: Walter
authors.initials: W
authors.lastname: Koltun
authors.affiliation: a Department of Surgery , The Galway Clinic , Galway , Ireland.|f Royal College of Surgeons Ireland , Galway , Ireland.
authors.forename: William P
authors.initials: WP
authors.lastname: Joyce
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003560:Cysts / Q000000981:diagnostic imaging / Q000453:epidemiology*; D004240:Diverticulum / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D052177:Kidney Diseases, Cystic / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011446:Prospective Studies; D011860:Radiography, Abdominal / Q000379:methods
keywords: Diverticular disease; benign cystic disease; connective tissue disorder; intra-abdominal cysts; renal cysts