Diverticulitis: Focused on Clinical Course and Relapse

Choi, Kwi Sook; Byeon, Jeong Sik; Yoon, Soon Man; Kim, Kyung Jo; Ye, Byong Duk; Myung, Seung Jae; Yang, Suk Kyun; Kim, Jin Ho

Abstract

BACKGROUND/AIMS: There are a limited number of studies concerning the outcomes of diverticulitis in the Oriental population. We sought to evaluate the clinical features and the long-term outcomes of diverticulitis in Korean patients. METHODS: We retrospectively reviewed the clinical courses of 104 patients (59 men, 45 women; median age 48.5 years [range: 24-83 years]) hospitalized for their first episode of diverticulitis between 1989 and 2005. RESULTS: Right-sided diverticulitis was more common (71/104, 68%). However, the proportion of left-sided diverticulitis increased as age increased. Thirty-two patients underwent operations: 30 because of complications and 2 because of presumed appendicitis. Left-sided diverticulitis was an independent risk factor for complications (OR=7.6, p<0.001), and it required surgical treatment more often than right-sided diverticulitis did (61% vs. 17%, p<0.001). Eighty-five patients were followed for a median of 36 months. Four of the 62 medically treated patients developed recurrence of diverticulitis, with a 3-year cumulative recurrence rate of 4.8%. None of the 4 recurrences showed complications, and all were successfully managed using conservative treatment. No predictive factors for the recurrence of diverticulitis could be determined. CONCLUSIONS: The recurrence rate and risk of complications associated with recurrence are low in patients treated conservatively for the first episode of diverticulitis. Therefore, elective surgery to prevent recurrence and complications should be utilized sparingly in patients with diverticulitis.