Diverticular Disease-Associated Colectomy in Urban African American Patients: A Hospital Based Study

Introduction: Diverticular Diseases (DD) are generally benign and are primarily detected as incidental findings during routine colonoscopies. However, in certain cases, DD might lead to colectomy. An estimated 25% of people affected by DD will experience acute symptoms at some point in time and 15-30% of these patients will require colectomy at some point in their life. In the present retrospective study, we sought to determine the frequency of colectomies in African American DD patients and the associated clinical and pathological features in such cases. Methods: We reviewed 2400 files that correspond to DD patients admitted at Howard University Hospital from 1996 to 2014. Clinical and pathological features of patients that resulted in colectomy were analyzed in details. Results were presented in frequency tables. Results: Among the 2400 DD cases, there were 60% (1438/2400) females and 40% (968/2400) males, of which 2020 (84%) had diverticulosis while 380 (16%) had diverticulitis. Colectomy was performed in 7.3% (174/2400) of the patients in the study. Six percent (112/2020) of patients who had colectomy were diagnosed with diverticulosis, and 16% (62/380) of patients had diverticulitis who underwent colectomy. From the diverticulosis set of colectomy patients, 82% (92/112) had hemorrhage, of which 30% (34/112) of them were admitted with massive GI bleeding. Of the diverticulitis set patients which had colectomy, 23% (14/62) had hemorrhage and 77% (48/62) had no hemorrhage. From the diverticulitis set of patients which had colectomy 50% (31/62) had recurrent diverticulitis (Table 1). Conclusion: This study reveals that a sizable portion of African Americans with DD undergo colectomy primarily due to hemorrhage in diverticulosis patients. This applies to diverticulitis patients as well, however, in these patients, recurrence of diverticulitis is the primary indicator for colectomy. In conclusion diverticulitis patients with recurrence and bleeding and diverticulosis patients with bleeding should be closely monitored to prevent unnecessary colectomies and mitigate the effects of such conditions on their overall health and colon integrity. Our study reveals that a sizable portion of African Americans, with Diverticular Disease will undergo colectomy primarily due to hemorrhage in diverticulosis patients.Figure 1