Manabe Noriaki, Haruma Ken, Nakajima Atsushi, Yamada Masami, Maruyama Yasuhiko, Gushimiyagi Masanori, Yamamoto Takatsugu
1 Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan 2 Department of General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan 3 Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan 4 Department of Gastroenterology, Hamamatsu Medical Center, Hamamatsu, Japan 5 Division of Gastroenterology, Fujieda Municipal General Hospital, Fujieda, Japan 6 Medical Examination Center of Chubu Medical Association, Chatan-cho, Japan 7 Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Dis Colon Rectum. 2015 Dec;58(12):1174-81. doi: 10.1097/DCR.0000000000000488.
Little is known about the epidemiology of diverticulitis in Japan. Additional information is needed about its clinical characteristics and the factors associated with complications of diverticulitis.
This study was designed to determine the clinical characteristics of diverticulitis and factors associated with its complications in Japanese patients.
This was a retrospective, multicenter, large-scale, cross-sectional study.
All of the consecutive patients in 21 Japanese hospitals with a final diagnosis of acute colonic diverticulitis were included in this study.
A total of 1112 patients, including 658 men and 454 women, with a mean age of 54.8 years, who were diagnosed by CT and/or ultrasonography between January 2006 and May 2011, were included in this study.
Data on medical history, investigations, treatments, and prognosis were collected using a standard form to create a dedicated database.
Clarification of the clinical characteristics of Japanese patients with acute diverticulitis was the main outcome measured.
Diverticulitis was detected mainly in men and women aged 40 to 60 years. Although diverticulitis more frequently affected the right colon (70.1%), diverticulitis of the left colon was significantly more frequent (61.0%) in elderly patients. Of the 1112 patients with diverticulitis, 179 (16.1%) developed complications, including abscess formation, perforation, stenosis, and/or fistula, some of which required surgical treatment, such as drainage or colonic resection. The duration of hospitalization (24.1 ± 19.5 days) and mortality rate (2.8%) were significantly higher in patients with versus without complications. Factors associated with complications were fever (>38.5°C), involvement of the left colon, higher age, and delayed diagnosis.
Limitations included the nonconsideration of diverticulitis treatment, the effect of dietary fiber, and the retrospective design of the study.
Complications were more frequent in elderly men with left-sided diverticulitis, although diverticulitis was more common in middle-aged people and on the right side of the colon. Factors associated with complications were fever, site of involvement, older age, and longer time until diagnosis.
在日本，关于憩室炎的流行病学情况知之甚少。需要更多有关其临床特征以及与憩室炎并发症相关因素的信息。
本研究旨在确定日本患者憩室炎的临床特征以及与其并发症相关的因素。
这是一项回顾性、多中心、大规模横断面研究。
本研究纳入了21家日本医院中所有最终诊断为急性结肠憩室炎的连续患者。
本研究共纳入1112例患者，其中男性658例，女性454例，平均年龄54.8岁，这些患者在2006年1月至2011年5月期间通过CT和/或超声检查确诊。
使用标准表格收集病史、检查、治疗和预后的数据，以创建一个专用数据库。
明确日本急性憩室炎患者的临床特征是主要观察指标。
憩室炎主要在40至60岁的男性和女性中被检测到。虽然憩室炎更常累及右半结肠（70.1%），但在老年患者中，左半结肠憩室炎明显更常见（61.0%）。在1112例憩室炎患者中，179例（16.1%）出现了并发症，包括脓肿形成、穿孔、狭窄和/或瘘管，其中一些需要手术治疗，如引流或结肠切除术。有并发症的患者住院时间（24.1±19.5天）和死亡率（2.8%）显著高于无并发症的患者。与并发症相关的因素包括发热（>38.5°C）、左半结肠受累、年龄较大和诊断延迟。
局限性包括未考虑憩室炎的治疗、膳食纤维的影响以及研究的回顾性设计。
虽然憩室炎在中年人和结肠右侧更常见，但左侧憩室炎的老年男性并发症更频繁。与并发症相关的因素是发热、受累部位、年龄较大和诊断时间较长。
