AB106. SOH22ABS161. An assessment of inpatient versus outpatient management of acute diverticulitis
General Session III

AB106. SOH22ABS161. An assessment of inpatient versus outpatient management of acute diverticulitis

Angus Lloyd1, Paul Cromwell1, Michael McNamara1, Conor Kearns2, Damian McCartan1

1Department of Surgery, St. Vincents University Hospital, Dublin, Ireland; 2Department of Surgery, Royal College of Surgeons, Dublin, Ireland

Background: Acute diverticulitis is one of the most common surgical presentations to the emergency department. Outpatient management of acute uncomplicated diverticulitis with oral antibiotics has been shown to be safe without increasing the risk of complications in comparison to inpatient management. The aim of the study is to assess the management of acute diverticulitis at our institution.

Methods: A single centre retrospective study was performed over a 7-month period (1st Feb 2020 to 31st Aug 2021). All patients with CT confirmed diverticulitis were included. Clinicopathological characteristics of included patients were recorded.

Results: A total of 100 patients with CT confirmed acute diverticulitis were included (mean age 57 years) (range, 30–90 years). Sixty-three patients had CT proven uncomplicated diverticulitis and 37 complicated diverticulitis. Mean C-reactive protein (CRP) was 81 mg/L in the uncomplicated group and 156 mg/L in the complicated group (P<0.001). Mean white cell count was 12.1×109/L and 20.6×109/L in the uncomplicated and complicated groups respectively (P=0.12). The average length of stay was considerably longer in the complicated group (17.4 vs. 4.3 days) (P=0.0001). Within the uncomplicated cohort only 9.5% (6/63) of patients were discharged home on the day of presentation for outpatient management.

Conclusions: The majority of patients with CT confirmed uncomplicated diverticulitis continue to be managed as inpatients despite evidence to support outpatient management. Factors that may contribute to this include limited access to CT imaging, over reliance on IV antibiotics and poor infrastructure to enable timely OPD follow up.

Keywords: Diverticulitis; outpatient; mild diverticulitis; uncomplicated diverticulitis; outpatient management

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-22-ab106
Cite this abstract as: Lloyd A, Cromwell P, McNamara M, Kearns C, McCartan D. AB106. SOH22ABS161. An assessment of inpatient versus outpatient management of acute diverticulitis. Mesentery Peritoneum 2022;6:AB106.

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