Is different approach needed for acute diverticulitis in younger patients?

Jan 25, 2011

A research team from Portugal compared the natural history and course of acute diverticulitis in a younger age group with an older population to evaluate whether younger patients should be managed differently. They recommended that diverticulitis management should be based on the severity of the disease and not on the age of the patient.

Acute diverticulitis is the most common complication of diverticular disease, and its clinical presentation varies from mild local inflammation to full-blown perforation. After resolution of an acute episode, the best management strategy is as yet undefined, due to the risk of further episodes and the risk associated with elective surgical resection. Historically, surgical resection has been advocated after one episode of complicated diverticulitis (diverticulitis with perforation of the bowel wall, which manifests as intra-abdominal abscesses or peritonitis) and after one episode of uncomplicated disease (local inflammation) for patients younger than 50 years old. However, this aggressive strategy for younger patients has been questioned by several researchers.

A research article to be published on January 14, 2011 in the addresses this question. The authors did a retrospective study to compare the natural history and the course of acute diverticulitis in a younger age group with that of an older population.

In this study, the patients younger than 50 years at first presentation of diverticulitis had less severe disease but a higher recurrence rate (25.8% vs 11.1%). All the patients with were managed with conservative treatment and for the majority of patients, the most severe attack of diverticulitis was the first. On multivariate analysis, age was the only factor predictive of recurrence.

The results show that acute diverticulitis is a mild disease with a low complication rate. In younger patients, there is a male predominance and the disease tends to be less severe than in the older age group, in spite of the higher recurrence rate. The clinical course of uncomplicated acute diverticulitis is similar both in younger and older patients. Therefore the same guidelines should be used in the treatment of both groups of patients.

Explore further: Prognostic factors identified for peripheral squamous cell carcinomas of the lung

More information: Faria GR, Almeida AB, Moreira H, Pinto-de-Sousa J, Correiada-Silva P, Pimenta AP. Acute diverticulitis in younger patients: Any rationale for a different approach? World J Gastroenterol 2011; 17(2): 207-212. www.wjgnet.com/1007-9327/full/v17/i2/207.htm

add to favorites email to friend print save as pdf

Related Stories

Predictors of ulcerative colitis severity

Jan 19, 2010

Ulcerative colitis (UC) is a chronic disease involving the large intestine which causes inflammation along with local and systemic symptoms. It affects individuals worldwide, with a higher prevalence in Canada. The course ...

Valuable baseline data of recent hepatitis A in Asian area

Mar 30, 2010

In Korea, there has been a rapid epidemiological shift in hepatitis A virus (HAV) infection as a result of rapid economic development. The adult cases of acute hepatitis A have increased rapidly during the past 10 years due ...

Recommended for you

Video: Is that double mastectomy really necessary?

Oct 24, 2014

When Angeline Vuong, 27,was diagnosed with cancer in one breast earlier this year, her first reaction was "A DOUBLE MASTECTOMY. NOW. " Turns out, she's far from alone: a recent JAMA study of 190,000 breast cancer cases in ...

User comments : 0