Department of General and Digestive Surgery, Reina Sofia University Hospital, Cordoba, Spain.
Unit of Coloproctology, Department of General and Digestive Surgery, Reina Sofia University Hospital, Cordoba, Spain.
J Dig Dis. 2017 Jul;18(7):379-387. doi: 10.1111/1751-2980.12487.
Acute diverticulitis (AD) is becoming a health concern with its increasing incidence. One of the accepted theories of the possible causes of diverticular perforation is the impaction of fecal residuals into some diverticula. We aimed to evaluate whether barium impaction had a negative effect by promoting diverticular inflammation or rupture and thereby AD recurrence.
A retrospective cohort study (January 2005-December 2015) was conducted at the Reina Sofia University Hospital of Cordoba, Spain with follow-up for patients received barium enema or not after their first episode of AD. Factors related to disease recurrence and its severity were analyzed.
In total, 349 patients were included and subdivided into the barium enema group (n = 141) and control group (n = 208), respectively. In the studied cohort, 72 (20.6%) patients suffered recurrence of AD, which was almost twice as frequent in the barium enema group than in the control group (27.7% vs 15.9%, P = 0.008). Patients who had undergone barium enema were more likely to present a higher Hinchey grade at recurrence than that observed in the index presentation (30.8% vs 9.1%, P = 0.024). Age <50 years, female sex, absence of treatment with rifaximin and especially barium enema, showed a trend to a higher probability of AD recurrence over time. However, no statistically significant differences were found.
We failed to conclude that barium enema increased AD recurrence. Patients undergo barium enema are more likely to show a higher Hinchey grade at recurrence than that observed in their index presentation.
急性憩室炎（AD）的发病率不断上升，成为一个健康问题。导致憩室穿孔的原因之一是粪便残留在某些憩室中嵌顿。我们旨在评估钡剂嵌塞是否通过促进憩室炎症或破裂从而导致 AD 复发而产生负面影响。
在西班牙科尔多瓦的雷纳索菲亚大学医院进行了一项回顾性队列研究（2005 年 1 月至 2015 年 12 月），对首次 AD 发作后接受或未接受钡灌肠的患者进行随访。分析了与疾病复发及其严重程度相关的因素。
共纳入 349 例患者，分为钡灌肠组（n = 141）和对照组（n = 208）。在研究队列中，72 例（20.6%）患者 AD 复发，钡灌肠组的复发率几乎是对照组的两倍（27.7%比 15.9%，P = 0.008）。接受钡灌肠的患者在复发时更有可能出现较高的 Hinchey 分级，高于首次就诊时的观察结果（30.8%比 9.1%，P = 0.024）。年龄<50 岁、女性、未使用利福昔明治疗，特别是钡灌肠，显示出 AD 复发的概率随时间增加的趋势。然而，未发现统计学差异。
我们未能得出钡灌肠会增加 AD 复发的结论。接受钡灌肠的患者在复发时更有可能出现较高的 Hinchey 分级，高于首次就诊时的观察结果。
