Impact of barium enema on acute diverticulitis recurrence: A retrospective cohort study of 349 patients

OBJECTIVE Acute diverticulitis (AD) is becoming a health concern with its increasing incidence. One of the accepted theories of the possible causes of diverticular perforation is the impaction of fecal residuals into some diverticula. We aimed to evaluate whether barium impaction had a negative effect by promoting diverticular inflammation or rupture and thereby AD recurrence. METHODS A retrospective cohort study (January 2005–December 2015) was conducted at the Reina Sofia University Hospital of Cordoba, Spain with follow‐up for patients received barium enema or not after their first episode of AD. Factors related to disease recurrence and its severity were analyzed. RESULTS In total, 349 patients were included and subdivided into the barium enema group (n = 141) and control group (n = 208), respectively. In the studied cohort, 72 (20.6%) patients suffered recurrence of AD, which was almost twice as frequent in the barium enema group than in the control group (27.7% vs 15.9%, P = 0.008). Patients who had undergone barium enema were more likely to present a higher Hinchey grade at recurrence than that observed in the index presentation (30.8% vs 9.1%, P = 0.024). Age