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Colonic diverticulitis in young A sians: a predominantly mild and right‐sided disease
Author(s) -
Tan KerKan,
Wong Jiayi,
Yan Zhiyan,
Chong ChoonSeng,
Liu Jody Z.,
Sim Richard
Publication year - 2014
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12273
Subject(s) - medicine , diverticulitis , odds ratio , incidence (geometry) , colectomy , retrospective cohort study , surgery , young adult , appendicitis , confidence interval , disease , general surgery , gastroenterology , ulcerative colitis , physics , optics
Background The management of diverticulitis in young A sian patients remains challenging. This study aimed to highlight the issues of managing diverticulitis in young A sians. Methods A retrospective review of all patients who were admitted for acute colonic diverticulitis from O ctober 2003 to D ecember 2008 was performed. Patients who were ≤50 year old were considered ‘young’ and formed the study group. Results The study group consisted of 142 patients. The majority ( n = 126, 88.7%) had right‐sided diverticulitis and most ( n = 117, 82.4%) were mild in severity. Most of the patients who underwent emergency surgery were for suspected appendicitis (39/56, 69.6%). When we compared between those aged ≤50 and >50 years, the older group had worse diverticulitis (odds ratio ( OR ), 4.90, 95% confidence interval ( CI ), 2.00–11.99), been operated for indications other than suspected appendicitis ( OR , 13.08, 95% CI , 5.42–31.56) and undergone a colectomy ( OR , 9.96, 95% CI , 4.12–24.10). The younger group had a much higher incidence of right‐sided disease ( OR : 7.80, 95% CI : 4.32–14.07). Over a median follow‐up of 40 (6–90) months, 7 (4.9%) patients were readmitted for a total of eight times for recurrent attacks of diverticulitis and all were successfully treated conservatively. Five other patients underwent elective surgery for persistent symptoms. Conclusion Diverticulitis in young Asians is often right‐sided and mild in severity. A significant proportion is only diagnosed when operated for presumed appendicitis. Recurrent attacks are uncommon and can often be treated non‐surgically.