کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4308030 1289267 2011 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Outcome of patients with acute sigmoid diverticulitis: Multivariate analysis of risk factors for free perforation
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی عمل جراحی
پیش نمایش صفحه اول مقاله
Outcome of patients with acute sigmoid diverticulitis: Multivariate analysis of risk factors for free perforation
چکیده انگلیسی

BackgroundSigmoid diverticulitis (SD) is common in the West; its incidence is increasing as the average age of the population increases. The aim of this study was to assess the clinical outcomes of patients with acute SD and to determine whether emergency operation was associated more often with previous episodes of acute diverticulitis.MethodsAll consecutive patients admitted for acute SD were recruited prospectively over an 11-year period from January 1998 to December 2008. Multiple logistic regression was used to identify risk factors for free perforation.ResultsWe included 934 patients (490 men and 444 women; median age, 59.2 years): 450 (48.2%) presented for their first SD episode and 484 (51.8%) had a prior history of SD. Free perforation occurred in 152 patients: during the first episode of SD in 114 patients (25.3%), during the second in 29 (12.7%), during the third in 8 (5.9%), and during the fifth in 1 patient (0.9%; P < .001). No patient with >5 previous episodes of SD had free perforation. All 152 patients with free perforation required emergent operative intervention. After initial conservative therapy in 782 patients, 82 required early elective operative intervention owing to exacerbation of infection under antibiotic treatment. Late elective colectomy was performed in 299 patients during the inflammation-free interval, and operative intervention was recommended in 345 patients owing to complicated diverticulitis. Uncomplicated SD in 56 patients was managed conservatively. Comorbidity (>1 disorder) and the first episode of SD were identified as risk factors for free perforation on multiple logistic regression.ConclusionThe risk of free perforation in acute SD decreases with the number of previous episodes of SD. The first episode thus is the most dangerous for a free perforation. The indication for colectomy should not be made based on the potential risk of free perforation.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Surgery - Volume 149, Issue 5, May 2011, Pages 606–613
نویسندگان
, , , , , ,