A Prospective Audit Of The Diversity Of Management Inn Acute Complicated Diverticulitis | 25297
Journal of Gastrointestinal & Digestive System
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Background: Acute complicated diverticulitis (ACD) is a common surgical emergency with significant implications for patients
like major surgical intervention, intensive care support and life-long stoma. However, there is currently no standardization of
care or unified national guidelines. The NICE guidelines stop short at when to refer patients to hospital. Although there are
various studies published relating to several management aspects of diverticulitis, none present good level 1 evidence. There
is a strong need to design good randomized controlled studies addressing various issues in ACD but for these to be of a
sufficiently high quality it is essential to define the current scale of the problem and variability in management trends. This
audit aims to provide landmark data on the national incidence, management strategies, short-term patient outcomes, stoma
rates and the role of surgical and radiological intervention.
Methods: A national audit over 3 months collecting information on patient demographics, presenting symptoms, number
of previous admissions, biochemistry, radiological imaging/intervention, surgical intervention, length and course of hospital
stay in ACD. This would be followed up by a one-off follow-up at 6 months from the date of admission to assess the further
proposed management with respect to diverticulitis.
Results: This abstract presents the protocol of the CADS audit.
Discussion: There are several unanswered questions relating to the management of ACD, the most pressing of these are roles
of and even the need for radiological and surgical intervention with respect to drainage of sepsis and washout, the role of major
surgical resection with or without primary anastomosis and stoma formation. All these parameters may differ with the age of
the patients who are now increasingly presenting at a younger age. There is a pressing need to define these problems, design
trials which could define and refine and streamline the currently diverse practice in this widely prevalent illness.
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