Ariam E, Richter V, Bermont A, Sandler Y, Cohen DL, Shirin H. Prior abdominal surgery as a potential risk factor for colonic diverticulosis or diverticulitis. World J Clin Cases 2023; 11(35): 8320-8329 [PMID: 38130607 DOI: 10.12998/wjcc.v11.i35.8320]
Corresponding Author of This Article
Daniel L Cohen, MD, Gastroenterologist, The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center, Zerifin 70300, Israel. docdannycohen@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
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World J Clin Cases. Dec 16, 2023; 11(35): 8320-8329 Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8320
Table 1 Demographic and epidemiologic characteristics of the patients with and without diverticulosis
Characteristics
Without diverticulitis, n = 268
With diverticulitis, n = 91
P value
Mean age
66.29
71.76
< 0.001
Male sex as %
53.7
52.7
0.870
Mean BMI
28.4
27.6
0.710
Origin
0.420
Israel
103 (38)
32 (35)
South Europe
93 (34)
27 (29)
Ethiopia
3 (1)
3 (3)
Sefaradi
58 (21)
24 (26)
Ashkenazi
11 (4)
5 (5)
Residence
Urban
254 (94)
85 (93)
0.620
Rural
14 (5)
6 (6)
Marital status
Married
179 (66)
23 (69)
0.660
Not married
89 (34)
28 (31)
Smoking
Never
123 (46)
52 (57)
0.190
Previous
90 (33)
24 (26)
Current
54 (20)
15 (16)
Alcohol
No drinking
196 (73)
67 (73)
0.920
Drinking
72 (27)
24 (27)
Red meat
None
23 (8)
4 (4)
0.065
< 3 times a week
213 (80)
83 (91)
> 3 times a week
28 (10)
4 (4)
Exercise
None
130 (48)
54 (59)
0.200
< 3 times a week
80 (30)
22 (24)
> 3 times a week
58 (21)
15 (16)
Education
< 12 yr
63 (23)
26 (28)
0.620
12 yr
84 (31)
27 (29)
> 12 yr
121 (45)
38 (41)
Chronic disease
Diabetes
98 (36)
31 (34)
0.660
IHD
57 (21)
23 (25)
0.420
HTN
156 (58)
62 (68)
0.094
COPD
22 (8)
7 (7)
0.870
CRF
17 (6)
4 (4)
0.490
Hypothyroidism
33 (12)
8 (8)
0.360
Vitamin D deficiency
103 (38)
31 (34)
0.450
Medications
Aspirin
97 (36)
34 (37)
0.840
NSAIDs
1 (0.4)
1 (1)
> 0.990
GC
2 (0.7)
4 (4)
0.038
Opiates
9 (3)
3 (3)
> 0.990
PPI
105 (39)
34 (37)
0.750
Table 2 Clinical indication for colonoscopy and endoscopic findings
Features
Without diverticulitis, n = 268
With diverticulitis, n = 91
P value
Indication of colonoscopy
0.55
Screening
49 (18)
10 (11)
Abdominal pain
22 (8)
10 (11)
Anemia
40 (15)
18 (19)
Rectal bleeding
24 (9)
9 (10)
Positive FOBT
17 (6)
9 (10)
Diarrhea
20 (7.5)
5 (5)
Constipation
10 (3)
5 (5)
History of polyps
61 (22)
16 (17)
Other
24 (9)
9 (10)
Polyps
0.10
None
177 (66)
52 (58)
Hyperplastic
12 (4)
1 (1)
Adenoma
69 (26)
33 (37)
Malignant
6 (2)
1 (1)
Hyperplastic + adenoma
2 (0)
2 (2)
Table 3 Association between previous surgery and diverticulosis
Feature
Without diverticulitis, n = 268
With diverticulitis, n = 91
P value
Any surgery
128 (47)
47 (49)
0.780
Ventral hernia
19 (7)
9 (9)
0.380
Inguinal hernia
18 (6)
16 (17)
0.002
Cholecystectomy
23 (8)
10 (11)
0.490
Gastric surgery
9 (3)
5 (5)
0.530
Appendectomy
39 (14)
6 (6)
0.048
Small bowel
6 (2)
0 (0)
0.340
Cesarean section
26 (9)
4 (4)
0.110
Gynecological
26 (9)
6 (6)
0.360
Urologic
12 (4)
6 (6)
0.410
Other
4 (1)
1 (1)
> 0.990
Table 4 Matching between patients with and without diverticulitis
Characteristics
Without diverticulitis, n = 59
With diverticulitis, n = 59
P value
Mean age
67
67
0.820
Male sex as %
57
57
Mean BMI
28
26
0.150
Origin
0.470
Israel
24 (47)
31 (52)
South Europe
19 (32)
12 (20)
Ethiopia
2 (3.4)
1 (1.7)
Sefaradi
12 (20)
11 (18)
Ashkenazi
2 (3)
4 (7)
Residence
0.620
Urban
56 (94)
58 (98)
Rural
3 (5)
1 (1)
Marital status
0.052
Married
36 (61)
46 (78)
Not married
23 (39)
13 (22)
Smoking
0.300
Never
32 (54)
23 (39)
Previous
15 (25)
25 (42)
Current
12 (20)
11 (18)
Alcohol
0.390
No drinking
80
83
Drinking
20
17
Red meat
0.280
None
1 (1.7)
5 (8)
< 3 times a week
54 (91)
48 (81)
> 3 times a week
4 (7)
6 (10)
Exercise
0.160
None
37 (62)
27 (45)
< 3 times a week
13 (22)
17 (29)
> 3 times a week
9 (15)
15 (25)
Education
0.820
Less than 12 yr
20 (56)
16 (44)
12 yr
18 (30)
18 (30)
More than 12 yr
21 (35)
24 (41)
Chronic disease
Diabetes
19 (32)
13 (22)
0.210
IHD
9 (15)
8 (13)
> 0.990
HTN
34 (58)
26 (44)
0.210
COPD
7 (11)
2 (3)
0.180
CRF
0 (0)
3 (5)
> 0.990
Hypothyroidism
6 (10)
6 (10)
> 0.990
Vitamin D def.
20 (34)
19 (32)
> 0.990
Medications
Aspirin
19 (32)
17 (28)
0.830
NSAIDs
1 (1.7)
1 (1.7)
> 0.990
GC
3 (5)
0 (0)
> 0.990
Opiates
2 (3)
0 (0)
> 0.990
PPI
20 (34)
16 (27)
0.540
Table 5 Association between previous surgery and diverticulosis after matching between patients with and without diverticulitis
Feature
Without diverticulitis, n = 59
With diverticulitis, n = 59
P value
Surgery
20 (66)
28 (52)
0.2
Ventral hernia
6 (10)
2 (3)
0.29
Inguinal hernia
10 (17)
10 (17)
> 0.99
Cholecystectomy
8 (13)
6 (10)
0.79
Gastric surgery
4 (7)
3 (1)
> 0.99
Appendectomy
5 (8)
8 (13)
0.58
Small bowel
0 (0)
0 (0)
0.34
Cesarean section
4 (7)
3 (5)
> 0.99
Gynecological
7 (12)
7 (12)
> 0.99
Urologic
2 (3)
0 (0)
> 0.99
Other
0 (0)
1 (2)
> 0.99
Citation: Ariam E, Richter V, Bermont A, Sandler Y, Cohen DL, Shirin H. Prior abdominal surgery as a potential risk factor for colonic diverticulosis or diverticulitis. World J Clin Cases 2023; 11(35): 8320-8329