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Management of Diverticulitis in Younger Patients

  • Published:
Diseases of the Colon & Rectum

Purpose

This study was designed to evaluate the clinical course of sigmoid diverticulitis patients younger than aged 50 years examined by abdominal CT during the first episode of disease to elucidate whether the criteria used for older patients can safely be followed in their younger counterparts.

Methods

Retrospective review of patients with sigmoid diverticulitis treated from 1990 to 2003 was performed. Inclusion criteria: patients younger than aged 50 years with sigmoid diverticulitis documented by CT scan. Severity of disease was classified according to radiographic findings. Age, gender, treatment, recurrent disease, and need for colostomy were documented.

Results

A total of 5,499 patients were identified with sigmoid diverticulitis: 962 patients were younger than aged 50 years, and 411 had a CT scan on their first episode of disease. Of the 411 patients, 335 were classified as uncomplicated and 76 were complicated. Of the uncomplicated patients, 101 underwent an elective operation and 234 were followed nonoperatively. Of those followed, 67 had a recurrent uncomplicated episode, 10 had a recurrent complicated episode, of whom 5 required emergent operation and colostomy. Of the 76 patients with complicated disease, 23 had an emergent operation with colostomy, and 38 had an elective operation. Fifteen patients were followed without an operation and seven had a recurrent uncomplicated episode. None required emergent operation or colostomy.

Conclusions

Younger patients with uncomplicated diverticulitis by CT criteria respond well to medical management and seldom required an emergent operation and colostomy. Young patients with diverticulitis should be treated according to the same criteria used for older patients.

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Acknowledgments

The authors thank Marshfield Clinic Research Foundation for its support through the assistance of Linda Weis and Alice Stargardt.

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Authors and Affiliations

  1. Department of General Surgery, Marshfield Clinic, Marshfield, Wisconsin, USA

    R. Scott Nelson D.O. & Alfonso Velasco M.D.

  2. Marshfield Clinic Research Foundation, Marshfield, Wisconsin, USA

    Bickol N. Mukesh Ph.D.

  3. Department of General Surgery, Marshfield Clinic, 1000 North Oak Avenue, Marshfield, Wisconsin, 54449, USA

    R. Scott Nelson D.O.

Authors
  1. R. Scott Nelson D.O.
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  2. Alfonso Velasco M.D.
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  3. Bickol N. Mukesh Ph.D.
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Correspondence to R. Scott Nelson D.O..

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Nelson, R.S., Velasco, A. & Mukesh, B.N. Management of Diverticulitis in Younger Patients. Dis Colon Rectum 49, 1341–1345 (2006). https://doi.org/10.1007/s10350-006-0655-6

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  • DOI: https://doi.org/10.1007/s10350-006-0655-6

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