Najah Yousif Abd Elwahab, Abdel Majed Mohammed Musaad and Nassir Alhaboob Arabi

Bleeding Diverticular Disease among Sudanese Patients, Study of 109 Patients in

Specialized Center

EP-07

Department of GI & HPB surgery, Ibn Sina Specialized Hospital, Khartoum, Suda

Contents:

• Objective

• Justification and rationale

• Introduction and literature review

• Materials and methods

• Results and discussion

• Conclusion

OBJECTIVES:

• To study rate and pattern of bleeding diverticular disease among Sudanese pa

tients.

• To determine site of bleeding, and associations of diverticular disease.

• To evaluate the most common risk factors in Sudanese patients.

• To evaluate the recurrence rate.

Justification:

Acute diverticular bleeding consider to be serious disease with severe morbidity

and mortality, while no research has been done on this area to identify rate ,patt

ern , recurrence ,risk factors and addresses those factors, it is essential to unders

tand and explore these factors for the scale-up of the proper treatment of bleedi

ng diverticular disease.

Introduction:

• Diverticulosis of the colon is an acquired condition that results from herniatio

n of the mucosa through defects in the muscle layer

• It was uncommon among Sudanese patients but recently it increasingly encou

ntered in Sudanese elderly patients.

• Bleeding Diverticular disease continues to be a dilemma in setting of emergen

cy.

• It can be triggered by aspirin, obesity and chronic diseases which may influen

ce the rate of recurrence.

Methods

• It is observational cross sectional hospital based study, it covered 109 patients

with bleeding diverticular disease in Ibn Sina Hospital.

• Data were analysed using SPSS version 25.0.

Figure (1) the distribution of the study participants according to their age - years (n = 109)

Figure (2)the distribution of the study participants according to their origin (n = 109)

Figure (3)the distribution of the study participants according to their occupation (n = 109)

Figure (4) the distribution of the study participants according to the type of chronic diseases (n = 94)

Figure (5) the distribution of the study participants according to the type of chronic medication (n = 61)

Figure (6) the distribution of the study participants according to site of diverticulosis (n = 109)

Figure (7) the distribution of the study participants according to their diet (n = 109)

Figure (8) the distribution of the study participants according to presence of other risk factors (n = 109)

Figure (9) the distribution of the study participants according to recurrence (n = 109)

Figure(10) the distribution of the study participants according to recurrence duration (n = 35)

Figure (11) the distribution of the study participants according to recurrence rate (n = 35)

Recurrent of bleeding diverticular disease

P valueYes

(n = 35)

No

(n = 74)

Total

(n = 109)

Freq. % Freq. % Freq. %

History of chro

nic illnesses

Diabetes

Yes 13 37.1 31 41.9 44 40.4

0.6371No

22 62.9 43 58.1 65 59.6

Hypertension

Yes 22 62.9 41 55.4 63 57.8

0.4620No

13 37.1 33 44.6 46 42.2

Asthma

Yes 5 14.3 14 18.9 19 17.4

0.5516No

30 85.7 60 81.1 90 82.6

CVD

Yes 6 17.1 6 8.1 12 11.0

0.1594No

29 82.9 68 91.9 97 89.0

CROSS TABULATION: (Table 12)

Table (13) the relation between the chronic medications with the recurrence

of bleeding diverticular disease among the study participants (n = 109)

Recurrent of bleeding diverticular

disease P

value Yes

(n = 35)

No

(n = 74)

Total

(n = 109)

Freq. % Freq. % Freq. %

History of

chronic

medication

Aspirin Yes 18 51.4 23 31.1 41 37.6

0.0406 No 17 48.6 51 68.9 68 62.4

Warfarin Yes 3 8.6 5 6.8 8 7.3

0.7345 No 32 91.4 69 93.2 101 92.7

Other

anticoagulant

Yes 3 8.6 11 14.9 14 12.8 0.3592

No 32 91.4 63 85.1 95 87.2

Table (14) the relation between the presence of malignancy/polyps/mass with

the recurrence of bleeding diverticular disease among the study participants

(n = 109)

Recurrent of bleeding diverticular

disease P

value Yes

(n = 35)

No

(n = 74)

Total

(n = 109)

Freq. % Freq. % Freq. %

History of

Colonoscopy

findings

Polyps Yes 2 5.7 3 4.1 5 4.6

0.6989 No 33 94.3 71 95.9 104 95.4

Mass Yes 2 5.7 0 0.0 2 1.8

0.0379 No 33 94.3 74 100.0 107 98.2

Conclusions:

• Bleeding diverticular disease is increasing among Sudanese patients, usually

it recurs after one month, and in most cases only one episode, it respond to c

onservative management, and few patients might needs surgical interventio

ns.

• Our study had some limitations. The relatively limited number of study parti

cipant (109 cases only recruited from one study area – Ibn Sina specialized h

ospital) may affect negatively the probability of finding more significant diffe

rences between different factors and characteristics, and recurrence of bleed

ing diverticulum disease among patients in Sudan.