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Prognostic factors from computed tomography in acute left colonic diverticulitis
P Ambrosetti1, J Robert, J A Witzig
1Clinic of Digestive Surgery, University Hospital, Geneva, Switzerland.
The British Journal of Surgery
|February 1, 1992
Summary
Younger men and patients with severe computed tomography (CT) findings after a first diverticulitis attack face higher risks of poor outcomes. This suggests considering elective colectomy for these individuals.
Area of Science:
- Gastroenterology
- Surgical Outcomes
Background:
- Diverticulitis is a common condition requiring management.
- Predicting outcomes after conservative treatment for acute left diverticulitis is crucial for patient care.
Purpose of the Study:
- To identify predictors of poor outcomes, including complications and recurrence, following a first episode of conservatively managed acute left diverticulitis.
Main Methods:
- Prospective study of 107 patients with a first attack of acute left diverticulitis.
- Outcomes assessed included persistent diverticulitis, recurrence, colonic stenosis, abscess, and fistula.
- Patient demographics (age, sex) and computed tomography (CT) findings were analyzed as potential predictors.
Main Results:
- Eight of 18 men aged 50 or younger experienced poor outcomes (P=0.032).
- Patients with severe CT findings (abscess, extraluminal air) had a significantly higher rate of poor outcomes (48%) compared to those with mild findings (16%) (P=0.004).
- Overall, 24 out of 107 patients had a poor outcome.
Conclusions:
- Age (≤50 years) and severe CT findings are significant predictors of poor outcomes after a first episode of acute left diverticulitis.
- Elective colectomy may be considered for men aged 50 or younger and/or patients with severe CT findings after an initial attack.