• Eur J Trauma Emerg Surg · Oct 2022

    Observational Study

    How to strengthen the management of acute diverticulitis: the utility of the WSES classification-a prospective single-center observational study.

    • Juan Carlos Sebastián-Tomás, Segundo Angel Gómez-Abril, Tomás Ripollés, Andrea Manrique, Teresa Torres-Sanchez, and María Jesús Martínez-Pérez.
    • Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Avenida Gaspar Aguilar 90, 46007, Valencia, Spain. jcst1990@gmail.com.
    • Eur J Trauma Emerg Surg. 2022 Oct 1; 48 (5): 4283-4291.

    PurposeThis study aimed to validate the World Society for Emergent Surgery (WSES) scale for the management of acute left-sided colonic diverticulitis (ALCD).MethodsAn observational study based on a prospective database of patients with ultrasound (US) and computerized tomography (CT) confirmed ALCD was conducted at our center from April 2018 to May 2019. The primary outcome was the success rate of outpatient management. Secondary outcomes were the association between different WSES stages, clinical and analytical parameters, treatments modalities, and outcomes, and the accuracy of US for management decisions.ResultsA total of 230 patients were included. Outpatient management was successful in 51/53 (96.23%) cases with ALCD stage 0 and 62/72 (86.11%) patients with stage 1A. There were no differences in age (p = 0.076) or the presence of pericolic air bubbles (p = 0.06) between patients who underwent admission or outpatient management. Clinical and analytical data, treatment decisions, and outcomes showed statistically significant differences between WSES stages. In 7/12 patients with stage 2A, percutaneous drainage or emergency surgery was required. All cases with stage 2B (distant air) underwent conservative management without the need for emergency or elective surgery. The accuracy of US WSES stages for management decisions, when compared with CT, was 96.96%.ConclusionThe WSES classification for ALCD seemed to be valid helping clinicians in the decision-making process to select between admission or outpatient management. Differences in clinical and analytical data, elected treatments, and outcomes were found between WSES stages. The US WSES stages showed high accuracy for management decisions.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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