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.