DIVERTICULAR DISEASE IN THE YOUNG AGE GROUP – CLINICAL COURSE AND MANAGEMENT

Abstract Diverticular disease is a common disease which is classically described in the elderly. However, recently its incidence in young patients is being reported more frequently. It has a wide spectrum of presentations ranging from asymptomatic diverticulosis to life-threatening forms. Classically, the diverticular disease in the young was considered a more virulent form with a higher recurrence rate necessitating more surgical interventions however, this old notion has been recently challenged. The aim is to study the clinical course of diverticular disease in the young age group < 50 years to evaluate the differences related to the predisposing risk factors, presentation, severity, complications, recurrence rate, and the management. Methods: A retrospective study of the patients admitted with diverticular disease in King Hamad University Hospital from 2016 to 2019. Patients were divided into 2 groups; group I (Young, <50) and group II (Old, ≥ 5). A comparison was held between the two groups according to the proposed risk factors, predictors of severity, the clinical, and the way of management. Different variables were analyzed using the appropriate statistical tests. Statistical significance was taken as P < 0.05. Results 134 patients were included; 76 (56.7%) males and 58 (43.3%) females. The median age was 59.5 (Min. – Max.) (25 – 89), Mean ± SD.58.2 ± 13.5. 115 (85.8%) patients presented with diverticulitis and 19 (14.2%) with diverticular bleeding. There was male predominance in the young group, p = 0.006. The old group showed a higher prevalence of DM, HTN and dyslipidemia, p= < 0.001 for all. Moreover, the old group showed lower haemoglobin and vitamin D levels with higher steroids intake, p = < 0.001, 0.001 and 0.004 respectively. There was no significant difference related to disease severity, management setting, antibiotics prescription, guided drainage, laparoscopic lavage or the need for surgery. However, recurrence was significantly higher in the young group, p= 0.046. Conclusion: Diverticular disease in the young age group under 50 is more predominant in males with a higher rate of recurrence. However, it is not a severe form of the disease and can be managed the same way as in the elderly.