Chan Dedrick Kok Hong, Tan Ker-Kan
Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore1E Kent Ridge Road, Singapore, 119228, Singapore.
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Int J Colorectal Dis. 2018 Jan;33(1):61-64. doi: 10.1007/s00384-017-2929-y. Epub 2017 Oct 31.
Diverticulitis in Asians is a different disease entity from Western counterparts. Few Asian studies have evaluated the management of acute Hinchey Ia diverticulitis with consideration for outpatient management. The purpose of this study was to evaluate the outcomes of Asian patients with Hinchey Ia acute diverticulitis.
A retrospective review of all patients who were treated for Hinchey Ia acute colonic diverticulitis between 2012 and 2014 was performed. All patients were diagnosed on computed tomography (CT).
There were 129 patients with Hinchey Ia acute diverticulitis. Fifty-five (42.6%) patients were male, and the median age was 54 years (range, 30-86). Eighty-seven (67.4%) patients had right-sided diverticulitis. Most patients were treated empirically with intravenous ceftriaxone and metronidazole (89.1%). They were then discharged with oral antibiotics. Only 6.1% of patients had a positive blood culture. The median length of stay in the hospital was 4 (range, 3-4) days. Only three (2.3%) patients were readmitted for acute diverticulitis within 30 days. They were managed with antibiotics and discharged well. The repeated CT scans reconfirmed Hinchey Ia diverticulitis. No patients required emergency surgery, and there were no 30-day mortalities.
Asian patients with Hinchey Ia diverticulitis recovered well with conservative management and could be amenable to outpatient therapy. Future prospective studies should be performed amongst Asians to evaluate managing this condition in an ambulatory setting.
亚洲人的憩室炎与西方人的憩室炎是不同的疾病实体。很少有亚洲研究评估过急性欣奇伊Ia级憩室炎的门诊治疗管理情况。本研究的目的是评估亚洲欣奇伊Ia级急性憩室炎患者的治疗结果。
对2012年至2014年间接受欣奇伊Ia级急性结肠憩室炎治疗的所有患者进行回顾性研究。所有患者均通过计算机断层扫描（CT）确诊。
共有129例欣奇伊Ia级急性憩室炎患者。55例（42.6%）为男性，中位年龄为54岁（范围30 - 86岁）。87例（67.4%）患者为右侧憩室炎。大多数患者经验性接受静脉注射头孢曲松和甲硝唑治疗（89.1%）。随后口服抗生素出院。仅6.1%的患者血培养呈阳性。住院中位时长为4天（范围3 - 4天）。仅3例（2.3%）患者在30天内因急性憩室炎再次入院。他们接受抗生素治疗后康复良好。重复的CT扫描再次确认了欣奇伊Ia级憩室炎。无患者需要急诊手术，且无30天内死亡病例。
亚洲欣奇伊Ia级憩室炎患者采用保守治疗恢复良好，适合门诊治疗。未来应在亚洲人群中开展前瞻性研究，以评估在门诊环境中管理这种疾病的情况。
