Acute sigmoid diverticulitis in young patients.

BACKGROUND/AIMS: The natural history of young patients admitted for acute diverticulitis in terms of the virulence of the disease and the need for surgical treatment has remained controversial.

METHODOLOGY

One thousand eighty-one patients with acute diverticulitis admitted to our hospital from 1986 to 2006 were identified from a computer database and their clinical course was analysed Patients under or over 50 years of age were compared regarding uncomplicated and complicated diverticulitis, the number of admissions, operative procedures performed, morbidity, mortality and recurrence of diverticulitis.

RESULTS

Eighty-one percent of the patients aged under 50 years were admitted for uncomplicated diverticulitis, whereas 36 % of the patients aged over 50 years were admitted for complicated diverticulitis (p = 0.001). Sixty-eight percent of the patients with uncomplicated diverticulitis and 79% of those admitted for diverticular perforation were admitted only once to our hospital. The male/female ratios of patients presenting with uncomplicated diverticulitis were 114/106 for patients aged under 50 years and 181/336 for patients aged over 50 years. The respective ratios for complicated diverticulitis were 36/17 and 111/179. Overall mortality for all the admitted patients was 2%, being 0% for patients aged under 50 years, 3% for patients aged over 50 years and 5% for those admitted for diverticular perforation. Recurrent symptoms of diverticulitis developed in 34% of the patients admitted the first time for acute diverticulitis and diverticular perforation occurred in 20% of the cases.

CONCLUSIONS

Young patients are more often admitted for uncomplicated diverticulitis than older patients. The course of the disease in patients aged less than 50 years is not more aggressive than in older patients.