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Diverticulitis recurrence after percutaneous abscess drainage

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Recurrent diverticulitis has been reported in 30–50% of patients who recover from an episode of diverticular-associated abscess. Our aim was to review the outcomes of patients who underwent non-operative management after percutaneous drainage (PD) of colonic diverticular abscess.

Methods

All patients with a diverticular-associated abscess were identified between 2001 and 2012. Individual charts were queried for peri-procedural data and follow-up. The most recent follow-up data were acquired via the electronic medical record or telephone call.

Results

A total of 165 patients underwent PD of diverticular-associated abscesses. Abscess locations were pelvic (n = 122), abdominal (n = 36), and both (n = 7), while median abscess size was 6.1 ± 2.2 cm. One hundred eighteen patients clinically improved following non-operative management, and 81 of these patients did not undergo subsequent colonic resection within 4 months of PD. Of these, 8 died within 12 months. Among the remaining 73 patients, there were no significant differences in demographics or abscess variables compared to those who underwent elective surgery within 4 months. Only 7 of 73 patients had documented episodes of recurrences, while 22 patients later had elective surgery (1.1 ± 1.2 years from the index case). Five-year colectomy-free survival was 55% (95%CI 42–66%), while the recurrence-free survival at 5 years was 77% (95%CI 65–86%). All recurrences were managed non-operatively initially and one patient went on to have elective resection.

Conclusion

A sizable number of patients successfully recover from complicated diverticulitis following PD. Subsequent non-operative management carries an acceptable risk for recurrent episodes and may be considered as a reasonable management option.

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Authors and Affiliations

  1. Ferguson Clinic/Spectrum Health, Division of Colorectal Surgery, Grand Rapids Medical Education Partners, Michigan State University, Grand Rapids, MI, USA

    Tarek Jalouta, Martin Luchtefeld & James W Ogilvie Jr

  2. Department of Colorectal surgery, West Virginia University Hospital, Morgantown, WV, USA

    Nezar Jrebi

Authors
  1. Tarek Jalouta
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  2. Nezar Jrebi
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  3. Martin Luchtefeld
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  4. James W Ogilvie Jr
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Corresponding author

Correspondence to James W Ogilvie Jr.

Additional information

Presented previously at the American College of Surgeons Clinical Conference 2014, San Francisco, CA, USA

Source of support: Ferguson Blodgett Foundation for Digestive Diseases

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Jalouta, T., Jrebi, N., Luchtefeld, M. et al. Diverticulitis recurrence after percutaneous abscess drainage. Int J Colorectal Dis 32, 1367–1373 (2017). https://doi.org/10.1007/s00384-017-2825-5

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  • DOI: https://doi.org/10.1007/s00384-017-2825-5

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