FTP2.1 Management settings and follow-up of acute diverticulitis

Abstract

Abstract Aims This audit evaluated our management of acute diverticulitis against the NICE and ACPGBI guidelines. We explored follow-up luminal investigations to ensure patients safety, and practicality of ambulatory management to potentially improve bed capacity and reduce costs. Method Retrospective data of patients presented acutely with CT-proven diverticulitis from 01/06/2021 to 31/10/2021 was collected. We focused on clinical, biochemical and radiological severity, management, and follow-up investigations. Results Records of 142 patients were evaluated, most of them had mild clinical disease with significant qSOFA score in only 8 patients. Most of patients had WCC of less than 15 and CRP of less than 100. Even in radiological severity, class 1a of modified Hinchey classification (uncomplicated disease) dominated with 96 patients. Interestingly, only 22 patients were treated via ambulatory care, while the remaining 120 received inpatient care. 10 of the inpatient treated patients required HDU/ ITU support and most of the hospital stays were 7 days or less. The treatment was predominantly non-operative, with only 4 patients required surgery and 6 others required radiological drainage. The 1-year follow-up showed only 16 readmissions. As for the follow-up investigations, 45 did not have any follow-up investigations or clinic reviews, 14 of them had complicated diverticulitis. Of the 97 patients who were followed up, 88 patients had endoscopic evaluation and 8 underwent CT colonography. Conclusion Since most patients of acute diverticulitis present with clinically, biochemically, and radiologically mild and uncomplicated disease, ambulatory management should be encouraged where possible. While 1-year readmissions remain low, it is crucial that patients, especially those with complicated disease, receive luminal investigations.