Recurrence and virulence of colonic diverticulitis in immunocompromised patients - 17/07/12
, Jaime Lopez Borao, M.D. a, Esther Kreisler, M.D., Ph.D. a, Thomas Golda, M.D., Ph.D. a, Monica Millan, M.D., Ph.D. a, Ricardo Frago, M.D. a, Domenico Fraccalvieri, M.D., Ph.D. a, Jordi Guardiola, M.D. b, Eduardo Jaurrieta, M.D., Ph.D. a
Corresponding author. Tel.: +34-93-260-7688; fax: +34-93-260-7485Abstract |
Background |
To evaluate the probability of recurrence and the virulence of colonic diverticulitis correlated with immunocompromised status.
Methods |
Nine hundred thirty-one patients admitted in a single tertiary referral university hospital over a 14-year period were included. Patients were divided into 2 groups: group 1, 166 immunosuppressed patients, and group 2, 765 nonimmunosuppressed patients. The variables studied were sex, age, American Society of Anesthesiologist status, reasons of immunosuppression (eg, chronic use of corticosteroids, transplant recipients, and diseases affecting the immune system), severity of the diverticulitis episode, recurrence, emergency and elective surgery, and morbidity and mortality rates.
Results |
Two hundred thirteen patients underwent an emergency operation during the first hospitalization and 26 patients in further episodes. One hundred thirty-six patients developed 1 or more recurrent episodes of diverticulitis. The overall recurrence rate was similar in both groups. Patients in group 1 with a severe first episode presented significantly higher rates of recurrence and severity without needing more emergency surgery. Mortality after emergency surgery was 33.3% in group 1 and 15.9% in group 2 (P = .004).
Conclusions |
After successful medical treatment of acute diverticulitis, patients with immunosuppression need not be advised to have an elective sigmoidectomy.
Le texte complet de cet article est disponible en PDF.Keywords : Colonic diverticulitis, immunosuppression, recurrence, severity, emergency surgery
Plan
| Supported by FIS grant number PI080989 from the Carlos III Institute, Ministry of Science and Innovation, Spain. |
Vol 204 - N° 2
P. 172-179 - août 2012 Retour au numéro
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