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Diverticular disease in younger patients – is it clinically more complicated and related to obesity?
Author(s) -
Pilgrim S. M.,
Hart A. R.,
Speakman C. T. M.
Publication year - 2013
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12225
Subject(s) - medicine , diverticular disease , diverticulitis , body mass index , etiology , disease , abdominal pain , diverticulosis , obesity , population , prospective cohort study , pediatrics , environmental health
Aim The aims of this systematic review were to determine the presentations of diverticular disease in patients under 40 years of age and to assess whether obesity is an important factor. Method The P ub M ed and EMBASE databases and the C ochrane L ibrary were searched to identify all original articles published between 1990 and 2011 on diverticular disease severity in obese patients (body mass index of ≥ 30 kg/m 2 ) under 40 years of age. Results Twenty‐three clinical case series (two of which were prospective) were identified plus two large aetiological population‐based studies. These reported that young patients with diverticular disease were presenting more frequently, that diverticular disease in this age group was less likely to be complicated but that emergency operation rates were higher. The majority (63.1–96.5%) of patients under 40 years of age with diverticular disease were obese. Conclusion The studies suggest that in the young, obese patient with lower abdominal pain, diverticulitis and appendicitis are included in the differential diagnosis. CT and/or laparoscopy should be considered where the diagnosis is in doubt.