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Prospective study on the management of patients with complicated diverticular disease

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Abstract Introduction 

Diverticular disease is a common condition with high morbidity and mortality related to its complications. The aim of this study was to assess the predictive role of acute diverticulitis in the development of further complications from diverticular disease. Patients and methods 

Prospective assessment of all patients with complicated diverticular disease over a 1-year period in a large teaching hospital was undertaken. All patients had documented evidence of their diagnosis by radiological, endoscopic or histopathological techniques when feasible. Results 

Seventy-seven patients with complicated diverticular disease were identified. There were 53 females and 24 males with a median age of 74 years (range 30–97 years). Complications included: acute diverticulitis (37), fistula (12), perforation (8), bleeding (7), abscess (7) and stricture (6). Only 8 had two or more previous documented episodes of diverticulitis. Twenty-five underwent surgery, 3 died (peritonitis 2, abscess1) and 5 had a complication (anastomotic dehiscence 1, adhesive obstruction 1, incisional hernia 2 and pneumonia 1). Three (5%) of 37 patients with acute diverticulitis had two or more admissions but none underwent surgery or developed further complications. CT was performed during acute admission in 14/37 patients with acute diverticulitis. The majority of patients with fistula (9/12), perforation 7/8, bleeding 6/7 and abscess 5/7 had no previous episode of diverticulitis while most patients with stricture (4/6) had previous documented episodes. Conclusion 

In our patient population acute diverticulitis is not a good predictor of the development of further complications from diverticular disease as only a minority of patients with perforation, fistula, abscess and bleeding had previous documented episodes of diverticulitis.
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Keywords: Complicated diverticular disease; acute diverticulitis; elective resection

Document Type: Research Article

Affiliations: 1: Department of Surgical Gastroenterology, Gartnavel General Hospital 2: University Department of Surgery, Western Infirmary, Glasgow, UK

Publication date: 01 March 2006

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