138 Overview of the management of acute uncomplicated diverticulitis in a District General Hospital
Ee Earn Chu, Kerushan Thomas, Mohamed Mostafa, Beatrice Robertson-Jones, Atiqur Rahman, Moutaz Alkhusheh- Surgery
Abstract
Aims
Acute diverticulitis is a condition where diverticula, which is the outpouching of the large intestinal mucosa; becomes inflamed or infected. We took recommendations from ACPGBI, WSES and NICE guidelines on the management of acute uncomplicated diverticulitis and compared our practice with them in a district general hospital.
Methods
Retrospective data collection of 50 consecutive patients presented to A&E with CT-proven acute uncomplicated diverticulitis was performed. Data included demographic distribution, clinical, laboratory and radiological features on presentation, treatment history and follow-up plans.
Results
All 30 patients being admitted with antibiotics, had modified Hinchey type 1a or 1b diverticulitis. However, 12 of these patients were over the age of 65 and another four had CRP >150. In the discharged group, all 20 patients had type 1a or 1b diverticulitis and almost all were discharged with antibiotics. However, 2 of these patients had CRP >150 and another five of them were over the age of 65. A request for the endoscopic procedure was placed for all 50 patients however 36 of them are still on the waiting list. Almost half of these patients were discharged without any written advice on discharge about the diverticular disease.
Conclusions
After analysing the data, more than half of these admitted patients could have been managed in ambulatory care without antibiotics. Conservatively managed diverticulitis patient doesn’t need routine endoscopic evaluation. All patients should have written advice given about their condition. We are in the process of making a pathway to ensure safe and cost-effective management for patients with acute diverticulitis.