Description of Clinical Presentation and Outcome of Colonic Diverticular Disease in Makah Region, Series of 62 Patients

Introduction: Colonic diverticulosis is a common disease in western population and rare in Saudi Arabia. Although the true prevalence of diverticular disease is not known, few papers came from Saudi Arabia presenting their experience. Aim: To determine the outcome of the disease, describe the clinical features, the role of CT-colonography in diagnosis, and the common site of the disease in Al-Noor specialist hospital in a holy city (Makah). Patients and Methods: The records of all patients with a diagnosis of diverticular disease (diverticulosis and diverticulitis) during 5-year's period (Jan 2011-Dec 2015) were reviewed retrospectively. The demographic data of the patients with the diagnosis of diverticulosis or diverticulitis were collected, included age, sex, nationality, clinical presentation, tool of diagnosing the disease and the colonic site of the disease. Results: A total of 62 patients were admitted to the surgical floor with a diagnosis of diverticular disease between Jan 2011 to Dec 2015. Fifty one patients were Saudi and thirty two patients had bleeding per rectum. Three patients presented with a localized abscess and drained percutanously while another patient had abdominal mass. Colonoscopy was done for 28 patients, CT scan with oral and I.V contrast was done for 33 patients and virtual colonoscopy for 6 patients. None of our patients admitted with symptomatic un-complicated diverticular disease required surgical intervention in the first admission. Three patients readmitted, 2 with bleeding diverticulosis and the third one with a cute diverticulitis. There was no mortality in my series. Conclusion: Colonic diverticulosis is increasing and the common clinical presentation is lower abdominal pain and massive lower gastrointestinal bleeding. The diagnosis is done during the acute presentation by CT scan or CT-colonography. Colonoscopy is diagnostic and therapeutic for lower GI bleeding.