Validation of a grading system for complicated diverticulitis in the prediction of need for operative or percutaneous intervention

A. K. Y. Fung, H Ahmeidat, D. McAteer, E. H. Aly (Corresponding Author)

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

INTRODUCTION: The current surgical management of acute complicated diverticulitis has seen a major paradigm shift from routine operative intervention to a more conservative approach. This has been made possible by the widespread availability of computed tomography (CT) to enable stratification of the disease severity of acute complicated diverticulitis. The aim of this study was to retrospectively validate a CT grading system for acute complicated diverticulitis in the prediction of the need for operative or percutaneous intervention.

METHODS: Hospital and radiology records were reviewed to identify patients with acute complicated diverticulitis confirmed by CT. A consultant gastrointestinal radiologist, blinded to the clinical outcomes of patients, assigned a score according to the CT grading system.

RESULTS: Three hundred and sixty-seven patients (34.6%) had CT performed for acute diverticulitis during the study period. Forty-four patients (12.0%) had acute complicated diverticulitis (abscess and/or free intraperitoneal air) confirmed on CT. There were 22 women (50%) and the overall median age was 59 years (range: 19-92 years). According to the CT findings, there was one case with grade 1, eighteen patients with grade 2, four with grade 3 and twenty-one with grade 4 diverticulitis. Three patients with grade 2, three patients with grade 3 and ten patients with grade 4 disease underwent acute radiological or surgical intervention.

CONCLUSIONS: The use of a CT grading system for acute complicated diverticulitis did not predict the need for acute radiological or operative intervention in this small study. Decision making guided by the patient's clinical condition still retains a primary role in the management of acute complicated diverticulitis.

Original languageEnglish
Pages (from-to)208-214
Number of pages7
JournalAnnals of the Royal College of Surgeons of England
Volume97
Issue number3
DOIs
Publication statusPublished - Apr 2015

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Diverticulitis
Tomography
Acute Disease
Hospital Records
Consultants
Radiology
Abscess
Decision Making
Air

Keywords

  • Diverticulitis
  • Grading
  • Intervention

Cite this

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title = "Validation of a grading system for complicated diverticulitis in the prediction of need for operative or percutaneous intervention",
abstract = "INTRODUCTION: The current surgical management of acute complicated diverticulitis has seen a major paradigm shift from routine operative intervention to a more conservative approach. This has been made possible by the widespread availability of computed tomography (CT) to enable stratification of the disease severity of acute complicated diverticulitis. The aim of this study was to retrospectively validate a CT grading system for acute complicated diverticulitis in the prediction of the need for operative or percutaneous intervention.METHODS: Hospital and radiology records were reviewed to identify patients with acute complicated diverticulitis confirmed by CT. A consultant gastrointestinal radiologist, blinded to the clinical outcomes of patients, assigned a score according to the CT grading system.RESULTS: Three hundred and sixty-seven patients (34.6{\%}) had CT performed for acute diverticulitis during the study period. Forty-four patients (12.0{\%}) had acute complicated diverticulitis (abscess and/or free intraperitoneal air) confirmed on CT. There were 22 women (50{\%}) and the overall median age was 59 years (range: 19-92 years). According to the CT findings, there was one case with grade 1, eighteen patients with grade 2, four with grade 3 and twenty-one with grade 4 diverticulitis. Three patients with grade 2, three patients with grade 3 and ten patients with grade 4 disease underwent acute radiological or surgical intervention.CONCLUSIONS: The use of a CT grading system for acute complicated diverticulitis did not predict the need for acute radiological or operative intervention in this small study. Decision making guided by the patient's clinical condition still retains a primary role in the management of acute complicated diverticulitis.",
keywords = "Diverticulitis, Grading, Intervention",
author = "Fung, {A. K. Y.} and H Ahmeidat and D. McAteer and Aly, {E. H.}",
note = "The material in this paper was presented at the European Society of Coloproctology annual meeting held in Vienna, September 2012, and published as an abstract in: Colorectal Dis 2012; 14(Suppl 2): 19.",
year = "2015",
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T1 - Validation of a grading system for complicated diverticulitis in the prediction of need for operative or percutaneous intervention

AU - Fung, A. K. Y.

AU - Ahmeidat, H

AU - McAteer, D.

AU - Aly, E. H.

N1 - The material in this paper was presented at the European Society of Coloproctology annual meeting held in Vienna, September 2012, and published as an abstract in: Colorectal Dis 2012; 14(Suppl 2): 19.

PY - 2015/4

Y1 - 2015/4

N2 - INTRODUCTION: The current surgical management of acute complicated diverticulitis has seen a major paradigm shift from routine operative intervention to a more conservative approach. This has been made possible by the widespread availability of computed tomography (CT) to enable stratification of the disease severity of acute complicated diverticulitis. The aim of this study was to retrospectively validate a CT grading system for acute complicated diverticulitis in the prediction of the need for operative or percutaneous intervention.METHODS: Hospital and radiology records were reviewed to identify patients with acute complicated diverticulitis confirmed by CT. A consultant gastrointestinal radiologist, blinded to the clinical outcomes of patients, assigned a score according to the CT grading system.RESULTS: Three hundred and sixty-seven patients (34.6%) had CT performed for acute diverticulitis during the study period. Forty-four patients (12.0%) had acute complicated diverticulitis (abscess and/or free intraperitoneal air) confirmed on CT. There were 22 women (50%) and the overall median age was 59 years (range: 19-92 years). According to the CT findings, there was one case with grade 1, eighteen patients with grade 2, four with grade 3 and twenty-one with grade 4 diverticulitis. Three patients with grade 2, three patients with grade 3 and ten patients with grade 4 disease underwent acute radiological or surgical intervention.CONCLUSIONS: The use of a CT grading system for acute complicated diverticulitis did not predict the need for acute radiological or operative intervention in this small study. Decision making guided by the patient's clinical condition still retains a primary role in the management of acute complicated diverticulitis.

AB - INTRODUCTION: The current surgical management of acute complicated diverticulitis has seen a major paradigm shift from routine operative intervention to a more conservative approach. This has been made possible by the widespread availability of computed tomography (CT) to enable stratification of the disease severity of acute complicated diverticulitis. The aim of this study was to retrospectively validate a CT grading system for acute complicated diverticulitis in the prediction of the need for operative or percutaneous intervention.METHODS: Hospital and radiology records were reviewed to identify patients with acute complicated diverticulitis confirmed by CT. A consultant gastrointestinal radiologist, blinded to the clinical outcomes of patients, assigned a score according to the CT grading system.RESULTS: Three hundred and sixty-seven patients (34.6%) had CT performed for acute diverticulitis during the study period. Forty-four patients (12.0%) had acute complicated diverticulitis (abscess and/or free intraperitoneal air) confirmed on CT. There were 22 women (50%) and the overall median age was 59 years (range: 19-92 years). According to the CT findings, there was one case with grade 1, eighteen patients with grade 2, four with grade 3 and twenty-one with grade 4 diverticulitis. Three patients with grade 2, three patients with grade 3 and ten patients with grade 4 disease underwent acute radiological or surgical intervention.CONCLUSIONS: The use of a CT grading system for acute complicated diverticulitis did not predict the need for acute radiological or operative intervention in this small study. Decision making guided by the patient's clinical condition still retains a primary role in the management of acute complicated diverticulitis.

KW - Diverticulitis

KW - Grading

KW - Intervention

U2 - 10.1308/003588414X14055925061315

DO - 10.1308/003588414X14055925061315

M3 - Article

VL - 97

SP - 208

EP - 214

JO - Annals of the Royal College of Surgeons of England

JF - Annals of the Royal College of Surgeons of England

SN - 0035-8843

IS - 3

ER -