Identifying patients with complicated diverticulitis, is it that complicated?
Ashraf Imam1, Elad Steiner2, Riham Imam1
1Department of Surgery, Hadassah Medical Center, Faculty of Medicine Hebrew University of Jerusalem, Israel.
Turkish Journal of Surgery
|December 9, 2022
Summary
Elevated white blood cell (WBC) counts in patients with acute diverticulitis indicate a higher risk of severe disease and the need for invasive treatment. Early CT scans are recommended for these patients.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Emergency Medicine
Background:
- Distinguishing simple from complicated diverticulitis clinically is difficult.
- Predictive factors for invasive treatment in acute diverticulitis are needed.
Purpose of the Study:
- To identify clinical predictors for invasive treatment in emergency room patients with acute diverticulitis.
Main Methods:
- Retrospective review of 809 patients diagnosed with diverticulitis.
- Comparison of clinical features, WBC, and Hinchey scores between conservative and invasive treatment groups.
Main Results:
- WBC at presentation was significantly higher in the invasive treatment group (13.72 vs. 11.46K/uL, p=0.024).
- Higher WBC correlated with higher Hinchey scores (13.16 vs 11.69, p <0.005).
- No significant differences in age, sex, fever, or BMI between groups.
Conclusions:
- Elevated WBC in acute diverticulitis suggests more severe disease and higher Hinchey scores.
- These patients may require invasive treatment, warranting CT evaluation.
- Clinical assessment combined with WBC and CT findings can guide treatment decisions.
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