Assessment of recurrence and complications following uncomplicated diverticulitis

Authors


Correspondence to: Dr P. Gervaz, Coloproctology Unit, Clinique La Colline, Avenue de la Roseraie 76A, 1205 Geneva, Switzerland (e-mail: pascalgervaz@gmail.com)

Abstract

Background

The natural history of sigmoid diverticulitis has been inferred from population-based or retrospective studies. This study assessed the risk of a recurrent attack following the first episode of uncomplicated diverticulitis.

Methods

Patients admitted between January 2007 and December 2011 with a first episode of uncomplicated sigmoid diverticulitis confirmed on computed tomography were enrolled in this prospective study. After successful medical management of the first episode, follow-up was conducted through yearly telephone interviews. Cox proportional hazards regression was performed to model the impact of various parameters on eventual recurrences and complications.

Results

During a median follow-up of 24 (range 3–63) months, 46 (16·4 per cent) of 280 patients experienced a second episode of diverticulitis. Six patients (2·1 per cent) subsequently developed complicated diverticulitis and four (1·4 per cent) underwent emergency surgery for peritonitis. In multivariable analysis, a raised serum level of C-reactive protein (over 240 mg/l) during the first attack was associated with early recurrence (hazard ratio 1·75, 95 per cent confidence interval 1·04 to 2·94; P = 0·035).

Conclusion

Uncomplicated sigmoid diverticulitis follows a benign course with few recurrences and little need for emergency surgery. Registration number: NCT01015378 (http://www.clinicaltrials.gov).

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