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Article

A Hospital Protocol for Decision Making in Emergency Admission for Acute Diverticulitis: Initial Results from Small Cohort Series

by
Paolo Ruscelli
1,
Roberto Cirocchi
2,
Alessandro Gemini
2,*,
Paolo Bruzzone
3,
Michelangelo Campanale
2,
Massimiliano Rimini
1,
Sergio Santella
1,
Gabriele Anaia
4,
Luigina Graziosi
2 and
Annibale Donini
2
1
Department of Emergency Surgery, Azienda Ospedaliero Universitaria-Ospedali Riuniti Ancona, 60126 Ancona, Italy
2
Department of Surgery and Biomedical Sciences, University of Perugia, 06121 Perugia, Italy
3
Department of General and Specialist Surgery “Paride Stefanini”, Sapienza University of Rome, 00161 Rome, Italy
4
Department of Morphology, Experimental Medicine and Surgery, Section of Surgery 1, Sant’Anna Hospital, University of Ferrara, 44121 Ferrara, Italy
*
Author to whom correspondence should be addressed.
Medicina 2020, 56(8), 371; https://doi.org/10.3390/medicina56080371
Submission received: 28 May 2020 / Revised: 17 June 2020 / Accepted: 6 July 2020 / Published: 24 July 2020
(This article belongs to the Section Surgery)
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Abstract

Background and objectives: We present initial results from a small cohort series for a hospital protocol related to the emergency hospitalization decision-making process for acute diverticulitis. We performed a retrospective analysis of 53 patients with acute diverticulitis admitted to the Department of Emergency and Trauma Surgery of the “Azienda Ospedaliero Universiaria-Ospedali Riuniti” in Ancona and to the Department of General and Emergency Surgery of the “Azienda Ospedaliera-Universitaria” in Perugia. Materials and Methods: All patients were evaluated according to hemodynamic status: stable or unstable. Secondly, it was distinguished whether patients were suffering from complicated or uncomplicated forms of diverticulitis. Finally, each patient was assigned to a risk class. In this way, we established a therapeutic/diagnostic process for each group of patients. Results: Non-operative treatment (NonOP) was performed in 16 patients, and it was successful in 69% of cases. This protocol primarily considers the patient’s clinical condition and the severity of the disease. It is based on a multidisciplinary approach, in order to implement the most suitable treatment for each patient. In stable patients with uncomplicated diverticulitis or complicated Hinchey grade 1 or 2 diverticulitis, the management is conservative. In all grade 3 and grade 4 forms, patients should undergo urgent surgery. Conclusions: This protocol, which is based on both anatomical damage and the severity of clinical conditions, aims to standardize the choice of the best diagnostic and therapeutic strategy for the patient in order to reduce mortality and morbidity related to this pathology.
Keywords: acute diverticulitis; complicated diverticulitis; emergency surgery; non-operative treatment; percutaneous drainage; Hartmann’s procedure; colon resection acute diverticulitis; complicated diverticulitis; emergency surgery; non-operative treatment; percutaneous drainage; Hartmann’s procedure; colon resection

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MDPI and ACS Style

Ruscelli, P.; Cirocchi, R.; Gemini, A.; Bruzzone, P.; Campanale, M.; Rimini, M.; Santella, S.; Anaia, G.; Graziosi, L.; Donini, A. A Hospital Protocol for Decision Making in Emergency Admission for Acute Diverticulitis: Initial Results from Small Cohort Series. Medicina 2020, 56, 371. https://doi.org/10.3390/medicina56080371

AMA Style

Ruscelli P, Cirocchi R, Gemini A, Bruzzone P, Campanale M, Rimini M, Santella S, Anaia G, Graziosi L, Donini A. A Hospital Protocol for Decision Making in Emergency Admission for Acute Diverticulitis: Initial Results from Small Cohort Series. Medicina. 2020; 56(8):371. https://doi.org/10.3390/medicina56080371

Chicago/Turabian Style

Ruscelli, Paolo, Roberto Cirocchi, Alessandro Gemini, Paolo Bruzzone, Michelangelo Campanale, Massimiliano Rimini, Sergio Santella, Gabriele Anaia, Luigina Graziosi, and Annibale Donini. 2020. "A Hospital Protocol for Decision Making in Emergency Admission for Acute Diverticulitis: Initial Results from Small Cohort Series" Medicina 56, no. 8: 371. https://doi.org/10.3390/medicina56080371

APA Style

Ruscelli, P., Cirocchi, R., Gemini, A., Bruzzone, P., Campanale, M., Rimini, M., Santella, S., Anaia, G., Graziosi, L., & Donini, A. (2020). A Hospital Protocol for Decision Making in Emergency Admission for Acute Diverticulitis: Initial Results from Small Cohort Series. Medicina, 56(8), 371. https://doi.org/10.3390/medicina56080371

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