yemenjmedYemen Journal of MedicinecoVolume 2 Issue 2 MultidisciplinaryEnglishMay-August 2023NNY20230928ArticleRecurrence patterns of acute colonic diverticulitis among patients admitted to Benghazi Medical Center, Benghazi, Libya: A retrospective and hospital-based studyEnglishY99104Naseralla Juma ElsaadiSuliman1EnglishNMarei Omar AliJahany2EnglishY10.32677/yjm.v2i2.4013Background: The normal pattern of acute colonic diverticulitis is still unknown, and prophylactic surgery after conservative treatment of diverticulitis is a topic of growing debate. The aim of this study was to investigate the patterns and frequency of recurrences and the likelihood of complications in conservatively treated uncomplicated and complicated diverticulitis in our epidemiological setting. Methods: This retrospective study was conducted to investigate 98 inpatients admitted to Benghazi Medical Center with acute colonic diverticulitis between February 2021 and August 2022. Acute diverticulitis discharge summaries were reviewed to identify eligible patients, and their medical records were meticulously reviewed retrospectively to confirm that their clinical presentation was consistent with colonic diverticulitis. Results: A retrospective study of 98 patients with acute colonic diverticulitis found that uncomplicated diverticulitis was associated with younger age, better 2-year survival rates, and more conservative management. Recurrence rates were almost similar between uncomplicated and complicated diverticulitis (23% vs. 25%) and typically occurred within 12 months of the initial attack. Surgical intervention was necessary for patients with perforations, while conservative management was used for other cases. Complications included abscesses in 44% of cases and perforations in 38% of cases. Conclusion: This study found that acute diverticulitis has a low recurrence rate and a limited propensity for progression into complications. It is recommended that elective surgery is used as a preventive measure against recurrences and associated complications. These findings have implications for clinical practice.EnglishColonic diverticulitis, Conservative treatment, Elective surgical procedures, Natural history, Retrospective studieshttps://www.yemenjmed.com/admin/abstract?id=64References1619Strate LL, Modi R, Cohen E, et al. Diverticular disease as a chronic illness: evolving epidemiologic and clinical insights. Am J Gastroenterol. 2012 Oct;107(10):1486-93.Weizman AV, Nguyen GC. Diverticular disease: epidemiology and management. Canadian Journal of Gastroenterology. 2011;25(7):385-9.Bharucha AE, Parthasarathy G, Ditah I, et al. Temporal trends in the incidence and natural history of diverticulitis: a population-based study. Am J Gastroenterol. 2015;110(11):1589.Stollman N, Smalley W, Hirano I, et al. American Gastroenterological Association Institute guideline on the management of acute diverticulitis. Gastroenterology. 2015;149(7):1944-9.Peery AF, Dellon ES, Lund J, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143(5):1179-87.Feingold D, Steele SR, Lee S, et al. Practice parameters for the treatment of sigmoid diverticulitis. Diseases of the Colon and;amp; Rectum. 2014;57(3):284-94.Peery AF, Sandler RS, Ahnen DJ, et al. Constipation and a low-fiber diet are not associated with diverticulosis. Clinical gastroenterology and hepatology. 2013;11(12):1622-7.Humes DJ, West J. Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the UK: population-based cohort study. Gut. 2012;61(1):95-100.Mosadeghi S, Bhuket T, Stollman N. Diverticular disease: evolving concepts in classification, presentation, and management. Current opinion in gastroenterology. 2015;31(1):50-5.Sallinen VJ, Mentula PJ, Leppand;auml;niemi AK. Nonoperative management of perforated diverticulitis with extraluminal air is safe and effective in selected patients. Diseases of the colon and;amp; rectum. 2014;57(7):875-81.Tursi A, Elisei W, Franceschi M, et al. The prevalence of symptomatic uncomplicated diverticular disease could be lower than expected: a single-center colonoscopy-based cohort study. European Journal of Gastroenterology and;amp; Hepatology. 2021;33(1S):e478-83.Kruis W, Germer CT, Leifeld L. Diverticular disease: guidelines of the german society for gastroenterology, digestive and metabolic diseases and the german society for general and visceral surgery. Digestion. 2014;90(3):190-207.Binda GA, Cuomo R, Laghi A, et al. Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines. Techniques in coloproctology. 2015;19:615-26.Regenbogen SE, Hardiman KM, Hendren S, et al. Surgery for diverticulitis in the 21st century: a systematic review. JAMA surgery. 2014;149(3):292-303.Sartelli M, Weber DG, Kluger Y, et al. 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting. World Journal of Emergency Surgery. 2020;15(1):1-8.Klarenbeek BR, Samuels M, van der Wal MA, et al. Indications for elective sigmoid resection in diverticular disease. Annals of surgery. 2010;251(4):670-4.Shahedi K, Fuller G, Bolus R, et al. Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy. Clinical gastroenterology and hepatology. 2013;11(12):1609-13.Hjern F, Wolk A, Hand;aring;kansson N. Obesity, physical inactivity, and colonic diverticular disease requiring hospitalization in women: a prospective cohort study. Official journal of the American College of Gastroenterology| ACG. 2012;107(2):296-302.Sand;oslash;reide K, Boermeester MA, Humes DJ, et al. Acute colonic diverticulitis: modern understanding of pathomechanisms, risk factors, disease burden and severity. Scandinavian Journal of Gastroenterology. 2016;51(12):1416-22.Sartelli M, Catena F, Ansaloni L, et al. WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting. World journal of emergency surgery. 2016;11(1):1-5.Salem L, Flum DR. Primary anastomosis or Hartmannand;rsquo;s procedure for patients with diverticular peritonitis? A systematic review. Diseases of the colon and;amp; rectum. 2004; 47:1953-64.Vennix S, Musters GD, Mulder IM, et al. Laparoscopic peritoneal lavage or sigmoidectomy for perforated diverticulitis with purulent peritonitis: a multicentre, parallel-group, randomised, open-label trial. The Lancet. 2015;386(10000):1269-77.Andeweg CS, Mulder IM, Felt-Bersma RJ, et al. Guidelines of diagnostics and treatment of acute left-sided colonic diverticulitis. Digestive surgery. 2014;30(4-6):278-92.Angenete E, Thornell A, Burcharth J, et al. Laparoscopic lavage is feasible and safe for the treatment of perforated diverticulitis with purulent peritonitis: the first results from the randomized controlled trial DILALA. Annals of surgery. 2016;263(1):117.Biondo S, Golda T, Kreisler E, et al. Outpatient versus hospitalization management for uncomplicated diverticulitis: a prospective, multicenter randomized clinical trial (DIVER Trial).Angenete E, Bock D, Rosenberg Jet al. Laparoscopic lavage is superior to colon resection for perforated purulent diverticulitisand;mdash;a meta-analysis. International journal of colorectal disease. 2017;32:163-9.Margolin DA. Timing of elective surgery for diverticular disease. Clin Colon Rectal Surg. 2009 Aug;22(3):169-72.Salem L, Veenstra DL, Sullivan SD, et al. The timing of elective colectomy in diverticulitis: a decision analysis. Journal of the American College of Surgeons. 2004;199(6):904-12.Vennix S, Morton DG, Hahnloser D, et al. Research Committee of the European Society of Coloproctocology. Systematic review of evidence and consensus on diverticulitis: an analysis of national and international guidelines. Colorectal Disease. 2014;16(11):866-78.Hall JF, Roberts PL, Ricciardi R, et al. Long-term follow-up after an initial episode of diverticulitis: what are the predictors of recurrence?. Diseases of the colon and;amp; rectum. 2011;54(3):283-8.