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Epidemiological similarities between appendicitis and diverticulitis suggesting a common underlying pathogenesis

Edward H Livingston1, Thomas B Fomby, Wayne A Woodward

  • 1Division of Gastrointestinal and Endocrine Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9156, USA. edward.livingston@utsouthwestern.edu

Archives of Surgery (Chicago, Ill. : 1960)
|March 23, 2011
PubMed

Insights

Childhood appendicitis and adult diverticulitis share epidemiological features, suggesting a common cause. However, their disease progression and incidence trends differ significantly, indicating distinct pathophysiologies despite similarities.

Area of Science:

  • Gastroenterology
  • Epidemiology
  • Public Health

Background:

  • Nonperforating appendicitis primarily affects children, while nonperforating diverticulitis predominantly affects older adults.
  • Both conditions share epidemiological links to improved hygiene and low-fiber diets.

Purpose of the Study:

  • To investigate the hypothesis that nonperforating appendicitis and nonperforating diverticulitis are different manifestations of the same underlying colonic process.
  • To determine if these conditions exhibit temporal relationships in their incidence rates.

Main Methods:

  • Analysis of data from the National Hospital Discharge Survey (1979-2006).
  • Investigation of appendicitis incidence in children and diverticulitis incidence in adults.
  • Utilized unit root analysis for time trend stationarity and cointegration analysis for trend similarity.

Main Results:

  • Nonperforating appendicitis and diverticulitis incidence rates showed U-shaped secular trends.
  • Rates of perforating appendicitis and diverticulitis increased slowly over the study period.
  • Nonperforating appendicitis and diverticulitis rates were significantly cointegrated, suggesting a shared underlying trend.

Conclusions:

  • Childhood appendicitis and adult diverticulitis appear to be similar diseases with a common underlying pathogenesis.
  • Secular trends for the nonperforating and perforating forms of these diseases are markedly different.
  • Perforating appendicitis may not be an inevitable outcome of delayed treatment; appendicitis might be treatable with antibiotics, similar to diverticulitis.
Abstract

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