Long-term outcome of patients presenting with acute complications of diverticular disease.

The immediate management of acute diverticular disease is well defined but the risk of further complications and the long-term course of the disease, after conservative or surgical treatment, is not clearly documented. Over an 8-year period, a total of 164 patients (male/female = 69/95, median age 68 years) presented with acute complications of diverticular disease and were prospectively followed up for a median of 48 months. Medical treatment of acute diverticulitis was effective in 85% of 86 patients, with a mortality of 1.3% and a recurrence rate of 2% per patient year follow-up. All 37 patients presenting with bleeding responded to conservative management without mortality and a readmission rate, with further bleeding, of 5% per patient year. Patients who required colonic resection (n = 52), either as a single or staged procedure, had a mortality of 12% but with no further admissions with complications of diverticular disease. The low risk of readmission with recurrent disease after successful conservative treatment of the acute complications of diverticular disease does not justify elective operation in this group of patients.