Song Myung Eun, Jung Sung-Ae, Shim Ki-Nam, Song Eun Mi, Kwon Kyoung Joo, Kim Hye In, Yoon So Yoon, Cho Won Young, Kim Seong-Eun, Jung Hye-Kyung, Moon Il Hwan
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2013 Feb;61(2):75-81. doi: 10.4166/kjg.2013.61.2.75.
BACKGROUND/AIMS: The clinical course and the most appropriate management of colonic diverticulitis in young patients are currently unresolved. This retrospective study was designed to compare young patients (≤40 years) with older patients (>40 years) regarding clinical characteristics of acute colonic diverticulitis and to determine whether differences exist in treatment outcome.
Three-hundred sixty eight patients presenting with acute colonic diverticulitis from March 2001 through April 2011 at Ewha Womans University Mokdong Hospital were reviewed retrospectively. The differences in clinical characteristics, treatment modality and recurrence between each group were analyzed.
Two-hundred and six patients were aged 40 years or younger and 162 patients were older than 40 years. The older group was diagnosed more frequently with severe diverticulitis. Surgical treatment was significantly more frequent in the older group than in the younger group (15.4% vs. 4.4%, p<0.001). No significant difference was found in preatment modality between the two groups in patients with recurrence. The difference in recurrence between groups was not statistically significant. In multivariate analysis, left colonic diverticulitis was significantly associated with severe diverticulitis (OR, 14.651; 95% CI, 4.829-44.457) and emergency surgery (OR, 13.745; 95% CI, 4.390-43.031).
When patients with colonic diverticulitis are treated conservatively, young age is no longer an independent risk factor for subsequent poor outcome. Diverticulitis in young patients does not have a particularly aggressive or fulminant course. Therefore, we recommend that diverticulitis management should be based on the severity and location of the disease, and not on the age of the patient.
背景/目的：目前，年轻患者结肠憩室炎的临床病程及最恰当的治疗方法尚无定论。本回顾性研究旨在比较年轻患者（≤40岁）与老年患者（>40岁）急性结肠憩室炎的临床特征，并确定治疗结果是否存在差异。
回顾性分析2001年3月至2011年4月在梨花女子大学木洞医院就诊的368例急性结肠憩室炎患者。分析每组患者在临床特征、治疗方式及复发情况方面的差异。
206例患者年龄在40岁及以下，162例患者年龄大于40岁。老年组被诊断为重度憩室炎的频率更高。老年组手术治疗的频率显著高于年轻组（15.4%对4.4%，p<0.001）。复发患者中，两组在治疗方式上无显著差异。两组之间的复发差异无统计学意义。多因素分析显示，左半结肠憩室炎与重度憩室炎（比值比，14.651；95%可信区间，4.829 - 44.457）及急诊手术（比值比，13.745；95%可信区间，4.390 - 43.031）显著相关。
当结肠憩室炎患者接受保守治疗时，年轻不再是随后预后不良的独立危险因素。年轻患者的憩室炎病程并非特别侵袭性或暴发性。因此，我们建议憩室炎的治疗应基于疾病的严重程度和部位，而非患者年龄。
