Acute diverticulitis in the young: A 5-year retrospective study of risk factors, clinical presentation and complications

Aim: Acute diverticulitis in the young is considered to follow an aggressive course, but there is a paucity of data on factors that could determine a complicated course. Method: All patients of 18-40years of age diagnosed with acute diverticulitis from 1 January 2003 to 31 December 2008 were identified. Patients were included if they had computed tomography (CT) evidence of acute diverticulitis and at least one clinical feature. Demographics, body mass index, presenting symptoms/signs, CT location of diverticulitis and complications were noted. Fisher's exact test and a multivariate logistic regression analysis model were used to detect possible associations between clinical variables and complications. Results: There were 76 patients, of whom 23 (30.2%) had fever (>38°C) and 52 (68.4%) had leucocytosis (≥11000/mm ³). The majority [48 (63.1%)] were obese. A total of 29 (38.1%) patients had complications, with perforation [18 (62%)] being the most common. Twelve (15.7%) required surgical or radiological intervention. Fever of ≥38.0°C and a body mass index of ≥25 were independently associated with complications (P=0.04 and P=0.03, respectively). Conclusion: Fever (≥38°C) at presentation and a body mass index of≥25 may help to predict a complicated course of acute diverticulitis in patients under 40 years of age.