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Symptomatic Treatment for Uncomplicated Acute Diverticulitis : A Prospective Cohort Study

Show simple item record 2016-06-09T10:14:48Z 2017-09-07T21:00:36Z 2016-06-09
dc.title Symptomatic Treatment for Uncomplicated Acute Diverticulitis : A Prospective Cohort Study en
ethesis.discipline Gastroenterological Surgery en
ethesis.discipline Gastroenterologinen kirurgia fi
ethesis.discipline Gastroenterologisk kirurgi sv
ethesis.faculty Medicinska fakulteten sv
ethesis.faculty Lääketieteellinen tiedekunta fi
ethesis.faculty Faculty of Medicine en
ethesis.faculty.URI Helsingfors universitet sv University of Helsinki en Helsingin yliopisto fi
dct.creator Mali, Juha
dct.issued 2016
dct.language.ISO639-2 eng
dct.abstract Background: Even though evidence for non-antibiotic treatment of uncomplicated diverticulitis exists, it has not gained widespread adoption. Objective: The aim of this prospective single-arm study was to analyze safety and efficacy of symptomatic (non-antibiotic) treatment for uncomplicated diverticulitis during a 30-day follow-up period. Design: Single-arm prospective trial ( ID NCT02219698). Settings: An academic teaching hospital functioning as both a tertiary and secondary care referral center. Patients: Patients, who had computer tomography verified uncomplicated acute colonic diverticulitis (including diverticulitis with pericolic air), were evaluated for the study. Patients with ongoing antibiotic therapy, immunosuppression, suspicion of peritonitis, organ dysfunction, pregnancy, or other infections requiring antibiotics were excluded. Interventions: Symptomatic in- or outpatient treatment consisted of mild analgesics (non-steroidal anti inflammatory drug or paracetamol). Main Outcome Measures: The incidence of complicated diverticulitis was the primary outcome. Results: Overall, 161 patients were included in the study and 153 (95%) completed 30-day follow-up. Four (3%) of these patients were misdiagnoses (abscess in the initial computer tomography scan). Total of 14 (9%) patients had pericolic air. Altogether, 140 (87%) patients were treated as outpatients and 4 (3%) of them were admitted to hospital during the follow-up. None of the patients developed complicated diverticulitis or required surgery, but antibiotics were given to 14 (9%, 6 per oral, 8 intravenous) patients 2 days (median) after inclusion. Limitations: This study is limited by the lack of comparison group and relatively short follow-up. Conclusions: Symptomatic treatment of uncomplicated diverticulitis without antibiotics is safe and effective. en
dct.language en
ethesis.language English en
ethesis.language englanti fi
ethesis.language engelska sv
ethesis.supervisor Sallinen, Ville
ethesis.thesistype pro gradu-avhandlingar sv
ethesis.thesistype pro gradu -tutkielmat fi
ethesis.thesistype master's thesis en
dct.identifier.ethesis E-thesisID:6e40ac96-08a3-40f3-8958-3ff1cd00caf0
ethesis.degreeprogram Lääketieteen koulutusohjelma fi
ethesis.degreeprogram Medical curriculum en
ethesis.degreeprogram Medicinska utbildningsprogrammet sv
ethesis-internal.timestamp.reviewStep 2016-02-17 15:26:59:990
dct.identifier.urn URN:NBN:fi:hulib-201606092287
dc.type.dcmitype Text

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