REGULAR CONTENT
Final ID
628
Type
Educational Exhibit-Poster Only
Authors
M Uceda Arriola1, M Hamblin1
Institutions
1St Francis Hospital, Evanston, IL
Purpose
To review current literature regarding the non-operative management of patients who successfully underwent percutaneous drainage for diverticular abscesses.
Materials & Methods
Diverticular disease is one of the most costly gastrointestinal disorders in the U.S accounting for 300,000 hospitalizations per year.Diverticular abscesses present in 10-20% of patients with diverticulitis.Abscesses larger than 3 cm can be successfully managed with CT-guided percutaneous drainage.According to current surgical guidelines, elective sigmoidectomy should typically be considered after recovery from an episode of complicated diverticulitis.These recommendations have been challenged by several studies proposing observation over elective surgery.
Results
Elective surgery is routinely performed 6-8 weeks after resolution of complicated diverticulitis.This is based on the assumption that diverticulitis is a progressive disease and the complication rate increases with each subsequent attack.Recently, it has been shown most patients who present with complicated diverticulitis do so at the time of their first attack.Furthermore, the risk of requiring emergency surgery or stoma creation is not associated with elective surgery.Several studies have demonstrated non-operative management of diverticular abscesses after successful percutaneous drainage is a safe and effective option in a selected group of patients.Predictors of recurrence such as immunosuppression, chronic renal failure, vascular collagen disease or COPD may be important factors in the selection of patients who would benefit from this practice.Limitations of previous studies (sample size, limited follow-up and patient selection) favor the need for large-scale prospective studies to evaluate long-term outcomes from the interventional radiology standpoint.
Conclusions
Non-operative management after percutaneous drainage of diverticular abscesses appears to be a safe, effective and low cost therapeutic option in a selected group of patients.Risk factors associated with high recurrence rates may be useful in patient selection.Discussion from the interventional radiology point of view as well as prospective data are needed in this controversial matter.
Final ID
628
Type
Educational Exhibit-Poster Only
Authors
M Uceda Arriola1, M Hamblin1
Institutions
1St Francis Hospital, Evanston, IL
Purpose
To review current literature regarding the non-operative management of patients who successfully underwent percutaneous drainage for diverticular abscesses.
Materials & Methods
Diverticular disease is one of the most costly gastrointestinal disorders in the U.S accounting for 300,000 hospitalizations per year.Diverticular abscesses present in 10-20% of patients with diverticulitis.Abscesses larger than 3 cm can be successfully managed with CT-guided percutaneous drainage.According to current surgical guidelines, elective sigmoidectomy should typically be considered after recovery from an episode of complicated diverticulitis.These recommendations have been challenged by several studies proposing observation over elective surgery.
Results
Elective surgery is routinely performed 6-8 weeks after resolution of complicated diverticulitis.This is based on the assumption that diverticulitis is a progressive disease and the complication rate increases with each subsequent attack.Recently, it has been shown most patients who present with complicated diverticulitis do so at the time of their first attack.Furthermore, the risk of requiring emergency surgery or stoma creation is not associated with elective surgery.Several studies have demonstrated non-operative management of diverticular abscesses after successful percutaneous drainage is a safe and effective option in a selected group of patients.Predictors of recurrence such as immunosuppression, chronic renal failure, vascular collagen disease or COPD may be important factors in the selection of patients who would benefit from this practice.Limitations of previous studies (sample size, limited follow-up and patient selection) favor the need for large-scale prospective studies to evaluate long-term outcomes from the interventional radiology standpoint.
Conclusions
Non-operative management after percutaneous drainage of diverticular abscesses appears to be a safe, effective and low cost therapeutic option in a selected group of patients.Risk factors associated with high recurrence rates may be useful in patient selection.Discussion from the interventional radiology point of view as well as prospective data are needed in this controversial matter.