Diverticular disease

2018 ◽  
pp. 333-340
Author(s):  
Abdullah Jibawi ◽  
Mohamed Baguneid ◽  
Arnab Bhowmick
Keyword(s):  
Conservative Treatment ◽  
Diverticular Disease ◽  
Ct Angiography ◽  
Disease Prevalence ◽  
Complicated Diverticulitis ◽  
Diverticular Bleeding ◽  
Treatment Management ◽  
Mesenteric Angiography ◽  
Hinchey Classification

Diverticular disease prevalence increases with age with up to 70% in octogenarians. Diverticulitis can be uncomplicated or complicated. The Hinchey classification is used to categorize complicated diverticulitis and guides urgent treatment, which may range from antibiotics to laparotomy. Recommended investigations are outlined, as well as conservative treatment. Management of diverticular bleeding may be problematic and guidelines in this area are outlined including urgent colonoscopy, CT angiography, and therapeutic superselective mesenteric angiography.

scholarly journals Complicated Diverticular Disease

2020 ◽  
Author(s):  
Kathleen M. Coakley ◽  
Bradley R. Davis ◽  
Kevin R. Kasten
Keyword(s):  
Postoperative Complications ◽  
Diverticular Disease ◽  
Surgical Intervention ◽  
Management Strategies ◽  
Significant Risk ◽  
Complicated Diverticulitis ◽  
Careful Attention ◽  
Correct Treatment ◽  
Treatment Paradigm ◽  
Colonic Diverticular Disease

AbstractThe modern management of colonic diverticular disease involves grouping patients into uncomplicated or complicated diverticulitis, after which the correct treatment paradigm is instituted. Recent controversies suggest overlap in management strategies between these two groups. While most reports still support surgical intervention for the treatment of complicated diverticular disease, more data are forthcoming suggesting complicated diverticulitis does not merit surgical resection in all scenarios. Given the significant risk for complication in surgery for diverticulitis, careful attention should be paid to patient and procedure selection. Here, we define complicated diverticulitis, discuss options for surgical intervention, and explain strategies for avoiding operative pitfalls that result in early and late postoperative complications.

scholarly journals Role of Dietary Habits in the Prevention of Diverticular Disease Complications: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1288
Author(s):  
Marilia Carabotti ◽  
Francesca Falangone ◽  
Rosario Cuomo ◽  
Bruno Annibale
Keyword(s):  
Systematic Review ◽  
Diverticular Disease ◽  
Dietary Habits ◽  
Acute Diverticulitis ◽  
High Quality ◽  
Eligibility Criteria ◽  
Diverticular Bleeding ◽  
Recurrent Diverticulitis ◽  
Increased Risk

Recent evidence showed that dietary habits play a role as risk factors for the development of diverticular complications. This systematic review aims to assess the effect of dietary habits in the prevention of diverticula complications (i.e., acute diverticulitis and diverticula bleeding) in patients with diverticula disease. PubMed and Scopus databases were searched up to 19 January 2021, 330 records were identified, and 8 articles met the eligibility criteria and were subjected to data extraction. The quality of the studies was evaluated by the Newcastle-Ottawa quality assessment form. No study meets the criteria for being a high-quality study. A high intake of fiber was associated to a decreased risk of diverticulitis or hospitalization due to diverticular disease, with a protective effect for fruits and cereal fiber, but not for vegetable fiber; whereas, a high red meat consumption and a generally Western dietary pattern were associated with an increased risk of diverticulitis. Alcohol use seemed to be associated to diverticular bleeding, but not to recurrent diverticulitis or diverticular complications. Further high-quality studies are needed to better define these associations. It is mandatory to ascertain the role of dietary habits for the development of recurrent acute diverticulitis and diverticular bleeding.

scholarly journals Prognostic value of the Diverticular Inflammation and Complication Assessment (DICA) classification

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Nasi ◽  
A M Mastromatteo ◽  
G Cambiè ◽  
F Di Mario ◽  
W Elisei ◽  
...  
Keyword(s):  
Public Health ◽  
Diverticular Disease ◽  
Severity Score ◽  
Prognostic Value ◽  
Complicated Diverticulitis ◽  
Significant Relation ◽  
Colonic Diverticulosis ◽  
Time Period ◽  
Endoscopic Classification ◽  
The Cost

Abstract Colonic Diverticulosis is one of the most common anatomic alterations found in the clinical practice. This condition has 60% incidence in the population over 60 years old. About 20% of patients with this condition will develop Diverticular Disease, and 5% of them will evolve into Diverticulitis. The aim of the study is to analyse the validation of the classification considering the distribution of the severity DICA score between the patients with diagnosis of colonic Diverticulosis. We analysed and classified with DICA 5635 colonoscopies in the period between January 2012 and April 2018 and we obtained the Hospital Discharge Form from all the patients that had been admitted to the hospital in the same time period. The results showed that 69.9% of the patients were assigned to the score DICA1, 21% to DICA2 and 9.1% to DICA3. Ageing increased both the diagnosis of Diverticular Disease and the severity score. The severity was higher in female patients (DICA1=44.6%,DICA2=50.8%,DICA3=57.8%). The occurrence of complications overall was 5.4% and specifically: not complicated Diverticular Disease (DICA1=1%, DICA2=1.8%, DICA3=3.5%); not complicated Diverticulitis (DICA1=2.1%, DICA2=4.7%, DICA3=6.4%); Bleeding in Diverticulitis (DICA1=0.4%, DICA2=1.2%, DICA3=4.5%); Diverticular Perforation (DICA1=0.0%, DICA2=0.1%, DICA3=0.4%). The complications that needed a surgical procedure were for DICA1 about 0.2%, for DICA2 0.8% and for DICA3 2.5%. As well the average of the occupant days in the hospital and the cost, respectively, was for DICA1:8.5 days and 2300 €; for DICA2:9.5 days and 3080 €; for DICA 3:13 days and 4090 €. The majority of the patients with Diverticular Disease belonged to the severity score DICA1 and the patients classified with DICA3 were mainly female and older than 69 years old. The study confirmed the prognostic value of the endoscopic classification DICA since the occurrence of complication resulted in a statistically significant relation with the score DICA3. Key messages DICA classification was able to discriminate, based on endoscopic records, the patients that could develop complications for Diverticular Disease. DICA classification is a valid parameter to predict the outcome of the disease, with great impact on public health improving the effectiveness of treatment.

The Role of Colonoscopy in Managing Diverticular Disease of the Colon

2015 ◽  
Vol 24 (1) ◽  
pp. 85-93 ◽  
Author(s):  
Antonio Tursi
Keyword(s):  
Diverticular Disease ◽  
Average Risk ◽  
Diverticular Bleeding ◽  
Persistent Symptoms ◽  
Uncomplicated Diverticulitis ◽  
Promising Tool ◽  
Colonic Neoplasia ◽  
Predictive Role ◽  
Endoscopic Classification

Diverticulosis of the colon is frequently found on routine colonoscopy, and the incidence of diverticular disease and its complications appears to be increasing. The role of colonoscopy in managing this disease is still controversial.Colonoscopy plays a key role in managing diverticular bleeding. Several techniques have been effectively used in this field, but band ligation seems to be the best in preventing rebleeding. Colonoscopy is also effective in posing a correct differential diagnosis with other forms of chronic colitis involving colon harbouring diverticula (in particular with Crohn's disease or Segmental Colitis Associated with Diverticulosis). The role of colonoscopy to confirm diagnosis of uncomplicated diverticulitis is still under debate, since the risk of advanced colonic neoplasia in patients admitted for acute uncomplicated diverticulitis is not increased as compared to the average-risk population. On the contrary, colonoscopy is mandatory if patients complain of persistent symptoms or after resolution of an episode of complicated diverticulitis. Finally, a recent endoscopic classification, called Diverticular Inflammation and Complications Assessment (DICA), has been developed and validated. This classification seems to be a promising tool for predicting the outcome of the colon harboring diverticula, but further, prospective studies have to confirm its predictive role on the outcome of the disease.

scholarly journals S0170 Income as a Predictor of Diverticular Disease Prevalence in Philadelphia

2020 ◽  
Vol 115 (1) ◽  
pp. S68-S68
Author(s):  
Brenda French ◽  
Christine Shieh ◽  
Caroline Johnson
Keyword(s):  
Diverticular Disease ◽  
Disease Prevalence

scholarly journals How to use administrative data for surgical outcomes in acute diverticulitis

2016 ◽  
Vol 1 (1) ◽  
pp. 15 ◽  
Author(s):  
Michael K-Y Hong ◽  
Anita R Skandarajah ◽  
Omar D Faiz ◽  
Ian P Hayes
Keyword(s):  
New Zealand ◽  
Administrative Data ◽  
Surgical Outcomes ◽  
Acute Diverticulitis ◽  
Complicated Diverticulitis ◽  
Administrative Database ◽  
Coding System ◽  
Diverticular Bleeding ◽  
Predictive Values ◽  
Uncomplicated Diverticulitis

<p>The measurement of quality outcomes is crucial in surgical care. Administrative data are increasingly used but their ability to provide clinically useful information is reliant on how closely the coding can define a particular cohort.        In acute admissions for diverticular disease, it is important to differentiate between complicated and uncomplicated diverticulitis, and between diverticulitis and diverticular bleeding. We aim to develop a method to define clinically relevant cohorts of patients from an administrative database in acute diverticulitis. Codes for acute diverticulitis were found from the ICD-10-AM (Australia and New Zealand) coding system, and the accuracy was established with retrospective chart review and cross-referenced with a clinical database at a single institution. Coding of non-diverticular and missed diverticular  cases was examined to determine non-diverticular codes that could differentiate these cases. These were combined into  logic algorithms designed to differentiate between uncomplicated and complicated diverticulitis admissions derived from   an administrative database. Specific K57 diverticular codes possessed sensitivity and positive predictive values of 0.92    and 0.69 for uncomplicated diverticulitis, respectively, with 0.61 and 0.92 for complicated diverticulitis, respectively, based on 153 cases. Most of the missing cases were usually complicated diverticulitis whilst some cases coded incorrectly  as uncomplicated diverticulitis were often found as undifferentiated abdominal pain. Diagnostic codes combined into algorithms that accounted for predictable variations improved cohort definition. In conclusion, algorithms with combined codes improved definitions of clinically relevant cohorts for acute diverticulitis from an Australian or New Zealand administrative database. This method may be used to develop logic algorithms for other surgical conditions and enable widespread measurement of relevant surgical outcomes.</p>

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