Failure of Conservative Treatment of Acute Diverticulitis with Extradigestive Air

Background Medical management for perforated diverticulitis without abscess or peritonitis (PDwAP) has a success rate of 40–70%. Identifying patients with a risk of medical treatment failure would improve outcomes. The aim of this study was to identify the risk factors for failure of medical treatme...

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Bibliographic Details
Published in:World journal of surgery 2017-07, Vol.41 (7), p.1890-1895
Main Authors: Colas, P. A., Duchalais, E., Duplay, Q., Serra-Maudet, V., Kanane, S., Ridereau-Zins, C., Lermite, E., Aubé, C., Hamy, A., Venara, A.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Acute Disease
Acute Disease Aged C-Reactive Protein, analysis Conservative Treatment Diverticulitis, therapy Female Humans Male Middle Aged Pneumoperitoneum, therapy Retrospective Studies Treatment Failure
Acute Diverticulitis
Aged
Anastomotic Leakage
Blood
C-reactive protein
C-Reactive Protein - analysis
Cardiac Surgery
Conservative Treatment
Diverticulitis
Diverticulitis - therapy
Failure analysis
Female
General Surgery
Health risk assessment
Heart rate
Humans
Imaging
Life Sciences
Male
Management
Medical treatment
Medicine
Medicine & Public Health
Middle Aged
Multivariate analysis
Original Scientific Report
Patients
Peritoneal Fluid
Peritoneum
Peritonitis
Pneumoperitoneum - therapy
Retrospective Studies
Risk analysis
Risk factors
Sepsis
Surgery
Tachycardia
Thoracic Surgery
Treatment Failure
Vascular Surgery
Xenografts
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Summary:Background Medical management for perforated diverticulitis without abscess or peritonitis (PDwAP) has a success rate of 40–70%. Identifying patients with a risk of medical treatment failure would improve outcomes. The aim of this study was to identify the risk factors for failure of medical treatment in patients admitted with PDwAP. Methods This multicenter retrospective observational study included all consecutive patients admitted for PDwAP and not surgically treated over a 7-year period. Peritonitis classified on the Hinchey scale was excluded. Potential clinical, biological and radiological risk factors for medical treatment failure were collected and compared between the group of patient with a failure of medical treatment (F) and the group in which treatment did not fail. Data were collected at referral . Results Ninety-one patients were included, and 29 had a failure of treatment (31.9%). The median heart rate was different between the two groups ( p  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-017-3931-9