Towards a tailored approach for patients with acute diverticulitis and abscess formation. The DivAbsc2023 multicentre case–control study

• DOI: 10.1007/s00464-024-10793-z
• Publication Date: 2024-04-17T16:01:56Z
• Authors: Mauro Podda; Marco Ceresoli; Marcello Di Martino; Monica Ortenzi; Gianluca Pellino; Francesco Pata; Benedetto Ielpo; Valentina Murzi; Andrea Balla; Pasquale Lepiane; Nicolo’ Tamini; Giulia De Carlo; Alessia Davolio; Salomone Di Saverio; Luca Cardinali; Emanuele Botteri; Nereo Vettoretto; Pier Paolo Gelera; Belinda De Simone; Antonella Grasso; Marco Clementi; Danilo Meloni; Gaetano Poillucci; Francesco Favi; Roberta Rizzo; Giulia Montori; Giuseppa Procida; Irene Recchia; Ferdinando Agresta; Francesco Virdis; Stefano Piero Ber...; Martina Pellegrini; Massimo Sartelli; Federico Coccolini; Fausto Catena; Adolfo Pisanu
• Keywords: Diverticulitis; Diverticular disease

Abstract Background This multicentre case–control study aimed to identify risk factors associated with non-operative treatment failure for patients CT scan Hinchey Ib-IIb and WSES Ib-IIa diverticular abscesses. Methods included a cohort of adult experiencing their first episode CT-diagnosed abscess, all whom underwent initial comprising either antibiotics alone or in combination percutaneous drainage. The was stratified based on the outcome treatment, specifically identifying those who required emergency surgical intervention as cases failure. Multivariable logistic regression analysis independent employed. Results Failure conservative occurred 116 (27.04%). classification IIb (aOR 2.54, 95%CI 1.61;4.01, P < 0.01), tobacco smoking 2.01, 1.24;3.25, presence air bubbles inside abscess 1.59, 1.00;2.52, = 0.04) were predictors In subgroup abscesses > 5 cm, drainage not success 2.78, − 0.66;3.70, 0.23). Conclusions Non-operative is generally effective Tobacco smoking's role an factor underscores need targeted behavioural interventions disease management. diverticulitis patients, particularly young smokers, require vigilant monitoring due increased risks septic progression. Further research into efficacy image-guided should involve randomized, studies focussing homogeneous patient groups. Graphical abstract