Diverticulitis in the young patient

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Abdominal Surgery

Background:

• Diverticulitis predominantly affects older adults but can present severely in younger patients.
• Younger age is considered a relative indication for early surgical intervention in diverticulitis.
• The virulence and rarity of diverticulitis in young patients necessitate specific clinical evaluation.

Purpose of the Study:

• To evaluate the clinical experience with diverticulitis in patients aged 40 years and younger.
• To analyze surgical and non-surgical management outcomes for young diverticulitis patients.
• To assess complication rates and identify factors influencing outcomes in this demographic.

Main Methods:

• Retrospective chart review of 22 patients (age ≤40) diagnosed with diverticulitis over 20 years.
• Inclusion criteria: surgical confirmation, CT scan, or contrast enema.
• Data collected on symptoms, diagnostic findings, surgical procedures, complications, and outcomes.

Main Results:

• Mean age was 32.1 years; 87% had positive CT findings.
• 18 patients underwent surgery, 19 had sigmoid colon involvement.
• High complication rate (56%) observed, with septic complications linked to delayed surgery; two-stage procedures showed better outcomes than one-stage.

Conclusions:

• Diverticulitis in young patients is often a fulminant illness requiring early surgical intervention.
• Prompt surgical management is crucial to mitigate high complication rates and septic complications.
• Two-stage surgical procedures appear to yield better outcomes compared to one-stage approaches in this population.