Podium presentation at the Annual Meeting of the American Society of Colon and Rectal Surgeons, Vancouver, 17 May 2011.
A clinical and radiological comparison of sigmoid diverticulitis episodes 1 and 2
Version of Record online: 5 MAR 2012
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland
Volume 14, Issue 4, pages 463–468, April 2012
How to Cite
Gervaz, P., Platon, A., Widmer, L., Ambrosetti, P. and Poletti, P.-A. (2012), A clinical and radiological comparison of sigmoid diverticulitis episodes 1 and 2. Colorectal Disease, 14: 463–468. doi: 10.1111/j.1463-1318.2011.02642.x
- Issue online: 5 MAR 2012
- Version of Record online: 5 MAR 2012
- Accepted manuscript online: 4 APR 2011 10:53AM EST
- Received 15 January 2011; accepted 11 March 2011; Accepted Article online 4 April 2011
- CT scan
Aim After an initial uncomplicated attack, sigmoid diverticulitis may recur, but the morphological characteristics of recurrent diverticulitis have not been investigated. We compared the clinical and radiological severity, the respective location and clinical outcome of the first two episodes of sigmoid diverticulitis.
Method We reviewed the charts of 60 patients [median age 61 (range 31–90) years] who were admitted initially for a first episode of uncomplicated left colonic diverticulitis, and who were eventually readmitted for a second episode, both being documented by abdominal computed tomography (CT) scan.
Results The median delay between the two episodes was 19 (3–97) months. Six (10%) patients developed a second complicated episode of diverticulitis [Hinchey II (n = 2), CT-guided percutaneous drainage; Hinchey III (n = 3), emergency Hartmann’s operation; colovesical fistula (n = 1), elective sigmoid resection]. Fifty-four (90%) patients were admitted for a second episode of uncomplicated diverticulitis. In this group, the duration of hospital stay [11 (4–22) vs 10 (1–39) days, P = 0.28], serum levels of C-reactive protein [131 (31–350) vs 112 (22–333) mm, P = 0.62] and CT scan-based severity score [3 (1–6) vs 3 (0–7) points, P = 0.07] were similar between the two episodes. In 19 out of 54 (35%) patients with simple recurrent diverticulitis, although disease severity was similar, the disease topography differed and recurrence involved another segment of the left colon.
Conclusion The majority of patients who develop recurrence do so in a similar mode and location. However, 10% develop complicated diverticulitis and in 35% of patients recurrent diverticulitis occurs at a different location.