MEDICAL VERSUS SURGICAL-MANAGEMENT OF DIVERTICULITIS IN PATIENTS UNDER AGE 40

BACKGROUND: Diverticulitis in patients under age 40 is a distinct enti ty, We compared the medical versus surgical management of diverticulit is for complications and outcomes in these patients. METHODS: A retros pective review was performed for treatment, hospitalizations, complica tions, and outpatient visits, Complications included readmission, recu rrent symptoms after antibiotic therapy, and postoperative problems, R ESULTS: Twenty-nine patients had a radiographic or surgical diagnosis of diverticulitis (18 surgical, 11 medical). Medically managed patient s had significantly more emergency department visits (4.7 +/- 6.6 vers us 0.3 +/- 0.6, P less than or equal to 0.01), and readmissions (7 ver sus 4, P less than or equal to 0.02). Three surgical patients (17%) ha d a total of 6 complications as compared with 6 medical patients (55%) with 25 complications (chi square, P less than or equal to 0.05). Al medically I treated patients had recurrent symptoms, and 6 required su rgery, CONCLUSION: Medically managed patients had significantly more e mergency department visits and complications than those managed surgic ally. Surgery is the indicated treatment for the first episode of dive rticulitis in patients under age 40. (C) 1997 by Excerpta Medica, Inc.