Outcomes of colonic diverticulitis according to the reason of immunosuppression

• Emergency surgery mortality for diverticulitis in immunosuppressed patients is high.
• The reasons of immunosuppression does not influence mortality and recurrence.
• Persistence of symptoms or early recurrences should be indication for elective surgery.

BackgroundThe aims of this study were to analyze the relationship between the different causes of immunosuppression (IMS) and diverticulitis.MethodsIMS patients admitted for colonic diverticulitis were included in the study. Patients were divided in 5 groups according to the reasons of IMS: group I, chronic corticosteroid therapy; group II, transplant patients; group III, malignant neoplasm disease; group IV, chronic renal failure; group V, others immunosuppressant treatment. Rate of emergency surgery, outcomes in terms of postoperative mortality, and recurrence rate after nonoperative management were analyzed according to the reason of IMS.ResultsEmergency surgery was performed in 76 patients (39.3%). It was needed more frequently in group I. Overall, postoperative mortality was of 31.6% and recurrence rate after successful nonoperative management occurred in 30 patients (27.8%). No differences were observed among the groups.ConclusionsThe rate of emergency surgery in IMS patients at the first episode of acute colonic diverticulitis is high. Elective surgery in IMS patients should be individually indicated according to persistence of symptoms or early recurrences.