Diverticulitis in the United States: 1998–2005

Etzioni, David A.; Mack, Thomas M.; Beart, Robert W.; Kaiser, Andreas M.

doi:10.1097/sla.0b013e3181952888

Cited by 518 publications

(179 citation statements)

References 17 publications

Supporting

Mentioning

159

Contrasting

Unclassified

Order By: Relevance

“…14,15 Patients with diffuse peritonitis, resulting from colon perforation, and those for whom conservative management is unsuccessful may require an emergency or elective colectomy.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil to Lymphocyte Count Ratio Has a Close Association With Severe Acute Colonic Diverticulitis in Patients Undergoing Surgical Treatment

Kim

Moon

Yoon

et al. 2017

International Surgery

View full text Add to dashboard Cite

Objective: To investigate the diagnostic potential of neutrophil-to-lymphocyte count ratio (NLCR) for acute diverticulitis. Summary of Background Data: We evaluated NLCR in patients with acute colonic diverticulitis who were treated with conservative and surgical treatments. Methods: A total of 205 patients who underwent surgical treatment or conservative management of acute diverticulitis between 2012 and 2016 were reviewed. Patients' age; sex; hospital days; co-morbidity; complication; period of use of antibiotics; treatment method; body temperature; and initial laboratory results such as neutrophil count, lymphocyte count, NLCR, and serum levels of C-reactive protein (CRP) were assessed. Results: The median ages of the conservative and surgical treatment groups were 46 and 68 years, respectively. Median CRP and glucose levels were high in acute colonic diverticulitis patients who underwent surgical treatment (P < 0.001, P < 0.001). Albumin level was low in the surgical treatment group (P < 0.001). NLCR was significantly different in both groups (conservative management vs surgical treatment, 4.1 mg/L versus 8.5 mg/L; P < 0.001). Median white blood cells was 11.36 × 109/L in the conservative management group and 14.0 × 109/L in the surgical treatment group, with no significance (P = 0.071). Multivariate analysis revealed that NLCR >10.21 [odds ratio (OR) = 5.613, P = 0.022]; CRP >17.23 mg/L (OR = 4.241, P = 0.006); and albumin ≤3.5 (OR = 4.192, P = 0.036) were significant for acute colonic diverticulitis patients. Conclusion: NLCR, CRP, and albumin levels were significantly associated with acute colonic diverticulitis in the surgical treatment group, and NLCR was the most powerful predictive marker of severe acute colonic diverticulitis.

show abstract

“…14,15 Patients with diffuse peritonitis, resulting from colon perforation, and those for whom conservative management is unsuccessful may require an emergency or elective colectomy.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil to Lymphocyte Count Ratio Has a Close Association With Severe Acute Colonic Diverticulitis in Patients Undergoing Surgical Treatment

Kim

Moon

Yoon

et al. 2017

International Surgery

View full text Add to dashboard Cite

show abstract

“…Genelikle belirsiz klinik yakınmalara neden olur. Asya toplumlarında divertiküler hastalık sağ kolonda sık görülmesine rağmen, batı toplumlarında genellikle sol kolon yerleşimli olduğu saptanmıştır (3) . Acil yatış gerektiren kolorektal hastalıkların %41'i divertiküler hastalıktır ve bunların yaklaşık olarak %20'si ameliyat edilmektedir (4) .…”

Section: Introductionunclassified

The Diagnosis and Treatment Approach in Acute Colon Diverticulutis.

Emiroğlu¹,

Uğurlu²,

Karaalı³

et al. 2015

Tepecik Dergisi

View full text Add to dashboard Cite

ÖZETAmaç: Akut karın oluşturan akut divertikülitin (AD) cerrahi kliniklerinde tanı ve tedavisi tartışmalıdır. Çalışmamızda, genel cerrahi kliniğimizde tedavi edilen sol kolon (inen kolon, siğmoid ve rektum) yerleşimli akut divertikülit olgularının tanı ve tedavi yaklaşımlarının incelenmesi amaçlandı. Yöntemler: Eylül 2007-Kasım 2014 tarihleri arasında sol kolon, sigmoid ve rektum yerleşimli AD nedeniyle hastenemiz genel cerrahi kliniğinde tedavi edilen hastalar değerlendirildi. Veriler hasta dosyaları ve Medülla (Probel A.Ş.) elektronik hasta kayıt sisteminden retrospektif olarak toplandı. Hastaların demografik, ek-morbidite, klinik yakınmaları, görüntüleme ve laboratuvar bulguları kaydedildi. Divertikülitlerin sol kolondaki dağılımı, tıbbi tedavi ve cerrahi tedavi verileri, yapılan ameliyatın tipi, hastanede yatış süresi ve morbidite-mortalite verileri incelendi. Hastalar Hinchey sınflamasına göre sınıflandırıldı ve gruplandırıldı. Bulgular: Toplam 35 hasta dâhil edilen çalışmamızdaki ortalama yaş 56 (29-78) yıl idi. Hinchey sınflandırılmasına göre 24 (%68,4) olgu Hinchey 1-2 ve 11 (%31,4) olgu Hinchey 3-4 olarak değerlendirilmiştir. Klinik olarak en sık yakınmanın otuziki (%91,4) olguda karın ağrısı olduğu saptandı. Otuz beş (%100) olguda karın tomografisi, otuz üç (%94,3) olguda karın ultrasonografisi yapıldığı bulundu. Kolonoskopi 22 (%62,9) olguda yapılmıştır. En sık olarak 31 (%88,6) olguda sigmoid kolon divertiküliti saptanmıştır. Tüm olguların %48,6'sına medikal tedavi uygulanmıştır. Elektif cerrahi girişim %11,4 olguda yapılmıştır. En sık uygulanan cerrahi işlem %48,6 oranında Hartmann prosedürü idi. Yedi olguda (%20) komplikasyon ve üç (%8,7) olguda mortalite izlendi. Sonuç: Akut divertikülit uygun olgularda (Hinchey 1,2) medikal tedavi ile tedavi edilebilir. Klinik ve görüntüleme bulgularında hastalığın ileri evresinde (Hinchey 3,4) olanlar için acil cerrahi girişim uygulanmalıdır. Tanı, tedavi ve tüm sürecinin izlenmesinde karın görüntüleme yöntemleri önemli bir rolü vardır. Anahtar kelimeler: Akut divertikülit, tanı ve tedavi ABSTRACTObjective: In our study we aimed to evaluate the treatment and diagnosis of the cases with acute diverticulitis of the left colon (descendant colon, sigmoid and rectum) who had been treated in our clinic. Methods: The patients with AD in the left colon, sigmoid ve rectum who were treated in general surgery clinic of our hospital September 2007 and November 2014 were evaluated. The data was obtained retrospectively. from patient files and medulla (Probel Corporation), and patients' electronical recording system Demographics, additional-morbidity, clinical complaints, imaging and laboratuary findings were recorded. The distribution of diverticulitis in the left colon, the data about treatment and surgical treatment, the type of performed operation, duration of hospitalization and the data about mortality and morbidity were recorded. The patients were classified and grouped according to Hinchey classification. Results: Totally 35 patients were included in our study and the...

show abstract

“…These studies have reported a reduction in mortality following hospital admission over time with a reduction from 1.6% in 1998 to 1.0% in 2004-2005 and a 55% relative reduction in in-hospital mortality from 4.5% to 2.5% from [2002][2003][2004][2005][2006][2007] with a reduction in mortality following surgery for acute diverticulitis from 5.7% to 4.3% across the same period. [37] Need for colonoscopy at follow up Current guidelines still recommend routine follow-up colonoscopy after a first attack of acute diverticulitis to confirm the diagnosis and exclude malignancy. [38] The recommendation for colonoscopy after an episode of acute diverticulitis is merely based on expert opinion and dates back to the time before widespread use of CT to diagnose acute diverticulitis.…”

Section: Mortalitymentioning

confidence: 99%