Sigmoid Diverticulitis in Young Patients-A More Aggressive Disease than in Older Patients?

There is controversy over whether sigmoid diverticulitis (SD) is more aggressive with a higher risk of perforation in younger than in older patients. The aim of this study was to assess the clinical presentation and outcome of patients a parts per thousand currency sign40 and > 40 years old with acute diverticulitis. Consecutive admissions of all patients with acute SD were prospectively recruited from January 1998 to June 2010. A total of 1,019 patients were included: 513 (69 a parts per thousand currency sign40 years and 444 > 40 years) presented with their first episode, while 506 (20 a parts per thousand currency sign40 years, 486 > 40 years) had a prior history of SD. The percentage of patients with severe SD did not differ between the two age groups either for the first (covered perforation, 30.4% vs. 29.5%, p = 0.875; free perforation, 26.1% vs. 23.9%, p = 0.69) or for the recurrent episode (covered perforation, 15% vs. 8.2%, p = 0.287; free perforation, 5% vs. 4.1%, p = 0.846). Furthermore, the rate of emergency surgery did not differ between both age groups either for the first (26.1% vs. 23.9%, p = 0.690) or the recurrent episode (5% vs. 4.1%, p = 0.846). No differences in the rate of Hartmann's procedure (52.6% vs. 68.3%, p = 0.180) and failure of conservative treatment (3.4% vs. 4.9%, p = 0.607) were observed between younger and older patients. Acute SD in younger patients is not more aggressive and has no higher risk of perforation or need for emergency surgery compared to older patients.