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Sigmoid Diverticulitis in Young Patients—A More Aggressive Disease than in Older Patients?

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

There is controversy over whether sigmoid diverticulitis (SD) is more aggressive with a higher risk of perforation in younger than in older patients. The aim of this study was to assess the clinical presentation and outcome of patients ≤40 and >40 years old with acute diverticulitis.

Patients and Methods

Consecutive admissions of all patients with acute SD were prospectively recruited from January 1998 to June 2010.

Results

A total of 1,019 patients were included: 513 (69 ≤40 years and 444 >40 years) presented with their first episode, while 506 (20 ≤40 years, 486 >40 years) had a prior history of SD. The percentage of patients with severe SD did not differ between the two age groups either for the first (covered perforation, 30.4% vs. 29.5%, p = 0.875; free perforation, 26.1% vs. 23.9%, p = 0.69) or for the recurrent episode (covered perforation, 15% vs. 8.2%, p = 0.287; free perforation, 5% vs. 4.1%, p = 0.846). Furthermore, the rate of emergency surgery did not differ between both age groups either for the first (26.1% vs. 23.9%, p = 0.690) or the recurrent episode (5% vs. 4.1%, p = 0.846). No differences in the rate of Hartmann’s procedure (52.6% vs. 68.3%, p = 0.180) and failure of conservative treatment (3.4% vs. 4.9%, p = 0.607) were observed between younger and older patients.

Conclusion

Acute SD in younger patients is not more aggressive and has no higher risk of perforation or need for emergency surgery compared to older patients.

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Authors and Affiliations

  1. Department of General, Vascular and Thoracic Surgery, Charité–Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Jörg-Peter Ritz, Kai S. Lehmann, Heinz J. Buhr & Christoph Holmer

  2. Institute of Biometry and Clinical Epidemiology, Charité–Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany

    Andrea Stroux

Authors
  1. Jörg-Peter Ritz
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  2. Kai S. Lehmann
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  3. Andrea Stroux
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  4. Heinz J. Buhr
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  5. Christoph Holmer
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Correspondence to Christoph Holmer.

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Ritz, JP., Lehmann, K.S., Stroux, A. et al. Sigmoid Diverticulitis in Young Patients—A More Aggressive Disease than in Older Patients?. J Gastrointest Surg 15, 667–674 (2011). https://doi.org/10.1007/s11605-011-1457-2

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  • DOI: https://doi.org/10.1007/s11605-011-1457-2

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