Background: Acute diverticulitis of the left colon is common and mostly benign. Due to controversy in staging
systems and lack of adequate follow-up in most studies, good quality data to predict long term outcomes after
a first episode of uncomplicated diverticulitis are missing. The aim of this study, was to assess the long-term
risk for adverse outcomes after a first episode of uncomplicated diverticulitis.
Methods: All consecutive patients with a CT-scan documented first episode of acute uncomplicated
diverticulitis between January 2010 and June 2013 were included in the study. CT-scans and clinical records
were retrospectively reviewed. The primary endpoint was overall recurrence, secondary endpoint was surgery
for diverticular disease.
Results: One-hundred-five patients were included in the study with a median follow-up of 116.4 (4.9-154.7)
months. Of these, 51 (48.5%) patients had a recurrence, 11 (10.4%) had 4 or more episodes. Twenty-one (20%)
patients underwent sigmoidectomy, all in an elective setting, mostly due to multiple recurrent episodes. Upon
both univariate and multivariate analyses, male gender was identified as the only risk factor for surgery
(p=0.021).
Conclusion: After a decade of follow-up, one out of two patients will have experienced recurrence after a first
episode of uncomplicated diverticulitis. None of those patients required emergency surgery, but one out of 5,
mostly men, underwent elective sigmoidectomy for multiple recurrent episodes.