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Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Interventional Radiology

Background:

  • Diverticular abscesses are a common complication of diverticulitis.
  • Recurrent diverticulitis affects 30-50% of patients after an abscess episode.
  • Percutaneous drainage (PD) is a standard initial treatment for colonic diverticular abscesses.

Purpose of the Study:

  • To review the outcomes of patients managed non-operatively after percutaneous drainage of colonic diverticular abscesses.
  • To evaluate the efficacy and safety of non-operative management following PD.
  • To assess the risk of recurrence and need for subsequent surgery.

Main Methods:

  • Retrospective review of 165 patients who underwent PD for colonic diverticular abscesses between 2001 and 2012.
  • Data collection included peri-procedural details and follow-up information via electronic medical records and telephone calls.
  • Analysis of clinical improvement, recurrence rates, subsequent colectomy rates, and survival.

Main Results:

  • 118 patients (71.5%) improved with non-operative management after PD.
  • Of those who improved, 81 did not undergo colectomy within 4 months; 5-year colectomy-free survival was 55%.
  • Recurrence-free survival at 5 years was 77%; only 7 of 73 patients (who did not undergo early surgery) had documented recurrences.

Conclusions:

  • Non-operative management following PD for colonic diverticular abscesses is effective for a significant number of patients.
  • This approach carries an acceptable risk of recurrent episodes.
  • Non-operative management after PD is a reasonable option for selected patients with colonic diverticular abscesses.