Diverticulitis: the effect of age and location on the course of disease

To examine the effect of patient's age and the location of diverticular dis ease on the course of the acute disease we retrospectively collected demogr aphic data, symptoms, laboratory findings, imaging techniques, type of trea tment (conservative vs. surgical), early and late complications, and follow -up data on 119 patients with acute diverticulitis (74 women, 45 men; mean age 64 +/- 14 years; follow-up 7-102 months. median 40). Patients were divi ded by their age into two groups (42 aged 60 years or younger, 77 aged over 60) and on the location of their disease (108 to the left of the middle tr ansverse, 11 to the right), Lower abdominal pain, abdominal tenderness, and fever were the most common complaints (70-97%). In the younger patients we found a significantly greater preponderance in the right colon (P = 0.02) than in older patients. Abdominal abscesses and fistulas were more common i n right-sided diverticulitis (P = 0.01). Patients with right-sided colon di verticulitis were treated surgically (82%) and on an emergency basis more o ften than patients with left-side colon diverticulitis (25%; P = 0.001), Ol der patients treated conservatively suffered more than younger patients (61 % and 33% respectively; P = 0.04) from recurrent abdominal pain but not fro m recurrent, confirmed diverticulitis. Patients with right-sided diverticul itis treated conservatively suffered more from recurrent diverticulitis epi sodes than patients with left-sided diverticulitis (P = 0.05). Younger pati ents thus do not have a more aggressive form of diverticulitis than older p atients. Patients with acute diverticulitis in the right colon are likely t o be operated earlier and for mistaken diagnoses than patients with left-si ded diverticulitis.