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The role of quantitative radiological measures of visceral adiposity in diverticulitis

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Abstract

Background

Diverticular disease has been linked to obesity. Recent studies have assessed the role of visceral adiposity with diverticulitis and its complications. The aim of this study was to evaluate the association of quantitative radiological measures of visceral adiposity in patients with diverticulitis with vital signs, biochemistry results, uncomplicated versus complicated diverticulitis and its interventions.

Methods

A retrospective analysis of all patients with diverticulitis admitted from November 2015 to April 2018 at a single institution was performed. Data collected included demographics, vital signs, biochemistry results, CT scan findings and management outcomes. The patients were divided into uncomplicated (U) and complicated diverticulitis (C) groups. Visceral fat area (VFA), subcutaneous fat area (SFA) and VFA/SFA ratio (V/S) were measured at L4/L5 level by the radiologist. Statistical analysis was performed to evaluate the association of VFA, SFA, V/S with the parameters in both U and C groups.

Results

352 patients were included in this study (U:C = 265:87). There was no significant difference in vital signs and biochemistry results in both groups. There was no significant difference in VFA, SFA, V/S ratios in both groups. In patients with V/S ratio > 0.4, they were 5.06 times more likely to undergo emergency intervention (95% CI 1.10–23.45) (p = 0.03). On multivariate analysis, a heart rate > 100 (OR 2.9, 95% CI 1.2–6.7), CRP > 50 (OR 3.4, 95% CI 1.9–6.0), WCC < 4 or > 12 (OR 2.1, 95% CI 1.2–3.6) and V/S ratio > 0.4 (OR 2.8, 95% CI 1.5–5.4) were predictive of complicated diverticulitis.

Conclusion

The quantitative radiological measurement of visceral adiposity is useful in prognostication in patients presenting with diverticulitis.

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Authors and Affiliations

  1. Department of General Surgery, St John of God Midland Hospital, 1 Clayton Street, Midland, WA, 6056, Australia

    Zi Qin Ng, Ruwan Wijesuriya, Kyaw Soe Moe & Mary Theophilus

  2. School of Medicine, University of Notre Dame, Fremantle, WA, Australia

    Ruwan Wijesuriya

  3. Perth Radiological Clinic, St John of God Midland Hospital, Midland, WA, Australia

    Philip Misur

  4. Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia

    Jih Huei Tan

  5. Curtin Medical School, Curtin University, Bentley, WA, Australia

    Mary Theophilus

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  1. Zi Qin Ng
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  2. Ruwan Wijesuriya
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  5. Kyaw Soe Moe
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Contributions

ZQN: Ethics application, study design, data collection and analysis, drafting of manuscript. RW: Co-design study, review of the manuscript, supervision of study. PM: Data collection for radiological measurements of visceral fat, review of the manuscript. JHT: Statistical analysis of data, review of manuscript. KSM: Data collection, review of manuscript. MT: Critical review of the manuscript, supervision of study. All authors approved the final version of the manuscript.

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Correspondence to Zi Qin Ng.

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Disclosures

Dr Zi Qin Ng, Dr Ruwan Wijesuriya, Dr Philip Misur, Dr Jih Huei Tan, Dr Kyaw Soe Moe and Dr Mary Theophilus have no conflict of interest or financial ties to disclose.

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Ng, Z.Q., Wijesuriya, R., Misur, P. et al. The role of quantitative radiological measures of visceral adiposity in diverticulitis. Surg Endosc 35, 636–643 (2021). https://doi.org/10.1007/s00464-020-07427-5

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  • DOI: https://doi.org/10.1007/s00464-020-07427-5

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