2026-04-17T20:12:45Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/115532025-10-24T10:33:30Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
Ceresoli, Marco
author
Ortenzi, Monica
author
Podda, Mauro
author
Di Martino, Marcello
author
Pellino, Gianluca
author
Pata, Francesco
2025-10-24T10:33:30Z
2025-10-24T10:33:30Z
2024-06-05T07:21:00Z2024-06-05T07:21:00Z2024-06
http://hdl.handle.net/11351/11553
Conservative treatment; Diverticular abscess; Percutaneous drainageTractament conservador; Abscés diverticular; Drenatge percutaniTratamiento conservador; Absceso diverticular; Drenaje percutáneoBackground
This multicentre case–control study aimed to identify risk factors associated with non-operative treatment failure for patients with CT scan Hinchey Ib-IIb and WSES Ib-IIa diverticular abscesses.
Methods
This study included a cohort of adult patients experiencing their first episode of CT-diagnosed diverticular abscess, all of whom underwent initial non-operative treatment comprising either antibiotics alone or in combination with percutaneous drainage. The cohort was stratified based on the outcome of non-operative treatment, specifically identifying those who required emergency surgical intervention as cases of treatment failure. Multivariable logistic regression analysis to identify independent risk factors associated with the failure of non-operative treatment was employed.
Results
Failure of conservative treatment occurred for 116 patients (27.04%). CT scan Hinchey classification IIb (aOR 2.54, 95%CI 1.61;4.01, P < 0.01), tobacco smoking (aOR 2.01, 95%CI 1.24;3.25, P < 0.01), and presence of air bubbles inside the abscess (aOR 1.59, 95%CI 1.00;2.52, P = 0.04) were independent predictors of failure. In the subgroup of patients with abscesses > 5 cm, percutaneous drainage was not associated with the risk of failure or success of the non-operative treatment (aOR 2.78, 95%CI − 0.66;3.70, P = 0.23).
Conclusions
Non-operative treatment is generally effective for diverticular abscesses. Tobacco smoking's role as an independent risk factor for treatment failure underscores the need for targeted behavioural interventions in diverticular disease management. IIb Hinchey diverticulitis patients, particularly young smokers, require vigilant monitoring due to increased risks of treatment failure and septic progression. Further research into the efficacy of image-guided percutaneous drainage should involve randomized, multicentre studies focussing on homogeneous patient groups.Open access funding provided by Università degli Studi di Cagliari within the CRUI-CARE Agreement. This research has not received any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
Avaluació de resultats (Assistència sanitària)
Drenatge quirúrgic
Diverticulosi
Intestins - Malalties - Tractament
Abscessos
DISEASES::Digestive System Diseases::Gastrointestinal Diseases::Gastroenteritis::Diverticular Diseases::Diverticulitis::Digestive System Diseases::Gastrointestinal Diseases::Diverticulitis, Colonic
Other subheadings::Other subheadings::/therapy
DISEASES::Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Drainage
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome::Treatment Failure
ENFERMEDADES::enfermedades del sistema digestivo::enfermedades gastrointestinales::gastroenteritis::enfermedades diverticulares::diverticulitis::enfermedades del sistema digestivo::enfermedades gastrointestinales::diverticulitis del colon
Otros calificadores::Otros calificadores::/terapia
ENFERMEDADES::infecciones bacterianas y micosis::infección::supuración::absceso::absceso abdominal
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::drenaje
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento::fracaso del tratamiento
Towards a tailored approach for patients with acute diverticulitis and abscess formation. The DivAbsc2023 multicentre case–control study
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion