PROGNOSTIC FACTORS IN COMPLICATED DIVERTICULITIS AT A TEACHING HOSPITAL IN SÃO PAULO

Introduction Acute diverticulitis (AD) occurs in approximately 15% of individuals with diverticular disease, being more common after the 6th decade of life and in male patients. Around 12% of these patients will present with complicated AD, and the treatment for cases with purulent or fecal peritonitis is typically surgical.

Objective To evaluate the epidemiological data of patients with complicated acute diverticulitis presenting with purulent and/or fecal peritonitis who underwent surgical treatment at a teaching hospital.

Methods This is a retrospective, clinical-observational study with a quantitative cohort approach, based on the analysis of electronic medical records from a teaching hospital in São Paulo, SP, Brasil.

Results Eighteen patients with Hinchey 3 and 4 diverticulitis who underwent emergency surgery were analyzed. The overall mean age was 54.9 years (ranging from 24 to 80), with 61.1% being male, and most patients had an ASA 3 anesthetic risk (72.2%). Among those with postoperative complications, the mean age was 58.9 years, and among those without complications, it was 47 years. Fourteen patients (77.7%) had comorbidities, of which 73.3% had Hinchey 3 AD and 100% had Hinchey 4 AD. Thirteen patients (72.2%) had C-Reactive Protein (CRP) levels greater than or equal to 250 mg/dL, and 88.8% showed leukocytosis.

Conclusion A higher incidence of complicated AD with purulent or fecal peritonitis was observed in older individuals, male patients, those with chronic diseases, those showing signs of peritonitis upon admission physical examination, and those with elevated leukocyte and C-reactive protein levels.

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Artikel online veröffentlicht:
25. April 2025