Outcome of a conservative policy for managing acute sigmoid diverticulitis

• Published in: British journal of surgery 2007-07, Vol.94 (7), p.876-879
• Main Authors: Shaikh, S., Krukowski, Z. H.
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Diverticulitis, Colonic - mortality; Diverticulitis, Colonic - surgery; Female; General aspects; Humans; Male; Medical sciences; Middle Aged; Miscellaneous; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Sigmoid Diseases - mortality; Sigmoid Diseases - surgery; Survival Analysis; Treatment Outcome
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.5703

Background: A conservative policy for patients presenting with acute sigmoid diverticulitis is associated with a low operation rate, and low overall and operative mortality rates. The long‐term consequences of such a policy were investigated. Methods: Data were collected prospectively for 232 patients with acute sigmoid diverticulitis between 1990 and 2004. Details of all subsequent readmissions were obtained and survival to August 2005 was analysed. Results: Of the 232 patients admitted, 60 (25·9 per cent) were known to have diverticulosis; in 172 patients it was a new diagnosis. Thirty‐eight patients (16·4 per cent) underwent sigmoid resection, with one death. Three elderly patients in whom a decision was made not to operate had perforated diverticulitis at autopsy. Of 191 patients discharged without resection, 35 (18·3 per cent) subsequently underwent sigmoid resection: 26 (13·6 per cent) elective and nine (4·7 per cent) emergency, with one death. Conclusion: A conservative policy is safe in both the short term and the long term. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Makes the case for conservative management