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Right colonic diverticulitis in Caucasians: presentation and outcomes versus left-sided disease

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Abstract

Purpose

To compare clinical features, computed tomography (CT) findings, and outcomes of right vs. left colonic diverticulitis (CD) in Caucasians.

Methods

This single-center retrospective case–control study of patients seen between July 2005 and February 2013 included 30 consecutive cases of right CD and 70 controls taken at random from a consecutive cohort of patients with left CD. The final diagnosis was established by consensus between a gastrointestinal surgeon and a gastrointestinal radiologist. Clinical features, treatment, and follow-up data were collected. Two radiologists blinded to patient data reached a consensus about multiple CT criteria. Cases and controls were compared using appropriate statistical tests, and odds ratios (ORs) associated with clinically meaningful variables were computed using univariate logistic regression.

Results

Median age was significantly lower in cases than in controls (48.5 years [IQR, 31–61] vs. 63.5 years [54–75], P < 0.0001). A body mass index <20 kg/m2 compared to >30 kg/m2 was associated with a higher risk of right than of left CD (OR 22.7, 95% confidence interval [95% CI], 2.6–200, P = 0.005). Compared to controls, cases more often had CT evidence of focal diverticular inflammation (86.7% [26/30] vs. 50% [35/70], P = 0.0006) and noncircumferential (≤180°) colonic wall thickening (66.7% [20/30] vs. 20% [14/70], P < 0.001). Complications were less common in the cases (6.7% [2/30] vs. 25.7% [18/70] than in controls, P = 0.03).

Conclusion

In Caucasians, right CD occurs in younger and thinner patients and carries a lower risk of complications compared to left CD. Focal diverticular inflammation by CT is more common in right than in left CD.

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Authors and Affiliations

  1. Department of Medical Imaging, Saint Joseph Hospital, 185 Rue Raymond Losserand, 75014, Paris, France

    Laura Valbousquet Schneider, Ingrid Millet, Isabelle Boulay-Coletta & Marc Zins

  2. Department of Medical Imaging, Begin Military Hospital, 69 Avenue de Paris, 94160, Saint Mandé, France

    Laura Valbousquet Schneider

  3. Department of Medical Imaging, CHU Lapeyronie, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier, France

    Ingrid Millet & Patrice Taourel

  4. Department of Gastrointestinal Surgery, Saint Joseph Hospital, 185 Rue Raymond Losserand, 75014, Paris, France

    Jérôme Loriau

Authors
  1. Laura Valbousquet Schneider
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  2. Ingrid Millet
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  3. Isabelle Boulay-Coletta
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  4. Patrice Taourel
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  5. Jérôme Loriau
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  6. Marc Zins
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Corresponding author

Correspondence to Ingrid Millet.

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Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The institutional review board of the Saint Joseph Hospital, Paris, France, approved this single-center case–control study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Statement of informed consent was not applicable since the manuscript does not contain any patient data.

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Schneider, L.V., Millet, I., Boulay-Coletta, I. et al. Right colonic diverticulitis in Caucasians: presentation and outcomes versus left-sided disease. Abdom Radiol 42, 810–817 (2017). https://doi.org/10.1007/s00261-016-0958-6

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  • DOI: https://doi.org/10.1007/s00261-016-0958-6

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