ArticleLangenbeck's archives of surgery2021
Radiologic predictors for failure of non-operative management of complicated diverticulitis: a single-centre cohort study.
Article in Langenbeck's archives of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Risk Prediction in Diverticulitis.Clinics in colon and rectal surgery · 2025Review
- Colonic Diverticulosis and Uncomplicated Diverticulitis Are Associated With a Lower Not Higher Risk of Mortality When Confounding Factors Are Held Constant.Journal of gastroenterology and hepatology · 2025Article
- Platelet to lymphocyte ratio is a risk factor for failure of non-operative treatment of colonic diverticulitis.Scientific reports · 2023Article
- Current Aspects on the Management of Perforated Acute Diverticulitis: A Narrative Review.Cureus · 2022Review
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeModern non-operative management of diverticulitis consists of a complex therapeutic regimen and is successful in most cases even of complicated diverticulitis. Still, a certain proportion of patients requires urgent surgery due to failure of the conservative approach. This study aims to identify predictors for failure of conservative treatment of complicated diverticulitis with the need for subsequent urgent resection during the acute episode.
methodsA single-centre retrospective cohort study was performed at our tertiary centre including cases of acute complicated diverticulitis (characterized by localized abscess formation and/or pericolic air) between 2007 and 2019 that were treated guideline-conform by multimodal conservative treatment. Radiologic characteristics of disease in CT scans upon admission were analysed by uni- and multivariable logistic regression to determine predictors for resection within 30 days after onset of the conservative therapy approach.
resultsA total of 669 cases of acute diverticulitis were identified, of which 141 patients met the inclusion criteria. Overall, 13% (n = 19) of patients were operated within 30 days despite initial conservative management. Multivariable logistic regression identified length of inflamed bowel greater than 7 cm (p < 0.011) and abscess formations >1 cm (p < 0.001) as significant risk factors for failure of conservative treatment.
conclusionPatients with length of inflamed bowel >7 cm or abscess formation >1 cm have increased risk for failure of conservative treatment of acute episodes of diverticulitis with contained perforations with subsequent need for urgent surgery. Therefore, conservative treatment of those patients should be monitored with special caution.
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