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Open Access 01-11-2021 | Diverticulitis | Original Article

Radiologic predictors for failure of non-operative management of complicated diverticulitis: a single-centre cohort study

Authors: Stefan Reischl, Kai Dominik Roehl, Sebastian Ziegelmayer, Helmut Friess, Marcus Richard Makowski, Dirk Wilhelm, Alexander Rudolf Novotny, Jochen Gaa, Philipp-Alexander Neumann

Published in: Langenbeck's Archives of Surgery | Issue 7/2021

Abstract

Purpose

Modern non-operative management of diverticulitis consists of a complex therapeutic regimen and is successful in most cases even of complicated diverticulitis. Still, a certain proportion of patients requires urgent surgery due to failure of the conservative approach. This study aims to identify predictors for failure of conservative treatment of complicated diverticulitis with the need for subsequent urgent resection during the acute episode.

Methods

A single-centre retrospective cohort study was performed at our tertiary centre including cases of acute complicated diverticulitis (characterized by localized abscess formation and/or pericolic air) between 2007 and 2019 that were treated guideline-conform by multimodal conservative treatment. Radiologic characteristics of disease in CT scans upon admission were analysed by uni- and multivariable logistic regression to determine predictors for resection within 30 days after onset of the conservative therapy approach.

Results

A total of 669 cases of acute diverticulitis were identified, of which 141 patients met the inclusion criteria. Overall, 13% (n = 19) of patients were operated within 30 days despite initial conservative management. Multivariable logistic regression identified length of inflamed bowel greater than 7 cm (p < 0.011) and abscess formations >1 cm (p < 0.001) as significant risk factors for failure of conservative treatment.

Conclusion

Patients with length of inflamed bowel >7 cm or abscess formation >1 cm have increased risk for failure of conservative treatment of acute episodes of diverticulitis with contained perforations with subsequent need for urgent surgery. Therefore, conservative treatment of those patients should be monitored with special caution.

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Title: Radiologic predictors for failure of non-operative management of complicated diverticulitis: a single-centre cohort study
Authors: Stefan Reischl
Kai Dominik Roehl
Sebastian Ziegelmayer
Helmut Friess
Marcus Richard Makowski
Dirk Wilhelm
Alexander Rudolf Novotny
Jochen Gaa
Philipp-Alexander Neumann
Publication date: 01-11-2021
Publisher: Springer Berlin Heidelberg
Keyword: Diverticulitis
Published in: Langenbeck's Archives of Surgery / Issue 7/2021
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-021-02244-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Radiologic predictors for failure of non-operative management of complicated diverticulitis: a single-centre cohort study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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