PDF(Pubmed)
Abstract：
Diverticulosis is not well characterized in the Caribbeans. Our aim was to compare the anatomical presentation of colonic diverticulosis in African Caribbeans (group AC) versus Europeans (group E) and severity.
We conducted a prospective controlled study involving 274 patients admitted for lower gastrointestinal haemorrhage (LGIH) in France (center 1: Guadeloupe; center 2: La Roche-sur-Yon); 179 cases with diverticular haemorrhage, including 129 in group AC and 40 in group E. Exploration of the colon included a detailed assessment of diverticula using a dedicated endoscopic grid.
AC and E had similar characteristics in terms of age, gender, previous history of LGIH, body mass index, dietary habits, and medications, but AC had significantly poorer hemodynamic parameters at admission and required more blood transfusions (66.7% vs. 42.5%; p=0.01) during hospitalization. Out of the 169 patients included in the study, a complete exploration of the colon was achieved in 81% (N = 137) (AC, n = 106; E, n = 31), and revealed right-side diverticulosis in AC (in 90.6%, included into a pancolonic form in 73.6% vs. 35.5%; p=0.0002) and left-side diverticulosis in E (in 96.8%, isolated form in 58.1% vs. 9.4%, p=0.0002). These data were confirmed by a sensitivity analysis using an endoscopic grid in 92 patients, achieving a higher frequency and larger size of diverticula in AC.
Our study has shown that diverticulosis was pancolonic in AC and more frequently associated with more severe haemorrhage than the left-sided diverticulosis of Europeans. This anatomical presentation may be driven by the genetic background more than the environment and diet.
We conducted a prospective controlled study involving 274 patients admitted for lower gastrointestinal haemorrhage (LGIH) in France (center 1: Guadeloupe; center 2: La Roche-sur-Yon); 179 cases with diverticular haemorrhage, including 129 in group AC and 40 in group E. Exploration of the colon included a detailed assessment of diverticula using a dedicated endoscopic grid.
AC and E had similar characteristics in terms of age, gender, previous history of LGIH, body mass index, dietary habits, and medications, but AC had significantly poorer hemodynamic parameters at admission and required more blood transfusions (66.7% vs. 42.5%; p=0.01) during hospitalization. Out of the 169 patients included in the study, a complete exploration of the colon was achieved in 81% (N = 137) (AC, n = 106; E, n = 31), and revealed right-side diverticulosis in AC (in 90.6%, included into a pancolonic form in 73.6% vs. 35.5%; p=0.0002) and left-side diverticulosis in E (in 96.8%, isolated form in 58.1% vs. 9.4%, p=0.0002). These data were confirmed by a sensitivity analysis using an endoscopic grid in 92 patients, achieving a higher frequency and larger size of diverticula in AC.
Our study has shown that diverticulosis was pancolonic in AC and more frequently associated with more severe haemorrhage than the left-sided diverticulosis of Europeans. This anatomical presentation may be driven by the genetic background more than the environment and diet.
摘要：
未经证实：在加勒比海地区并没有很好的表现。我们的目的是比较非洲加勒比海地区（AC组）与欧洲人（E组）的结肠憩室病的解剖学表现和严重程度。
UNASSIGNED：我们进行了一项前瞻性对照研究，涉及法国下消化道出血（LGIH）的274例患者（中心1：瓜德罗普岛；中心2：LaRoche-sur-Yon）；179例憩室出血，其中AC组129例,E组40例.结肠探查包括使用专用内镜网格对憩室进行详细评估.
UNASSIGNED：AC和E在年龄方面具有相似的特征，性别,LGIH以前的历史，身体质量指数,饮食习惯，和药物，但AC在入院时的血流动力学参数明显较差，需要更多的输血(66.7%vs.42.5%；p=0.01）住院期间。在纳入研究的169名患者中，81%(N=137)(AC，n=106；E，n=31),并显示AC的右侧憩室病（占90.6%，包括在一个pancolonic形式的73.6%与35.5%；p=0.0002)和左侧憩室病(96.8%，分离形式在58.1%与9.4%,p=0.0002)。这些数据通过使用内窥镜网格对92例患者进行的敏感性分析得到证实，在AC中实现更高的频率和更大的憩室尺寸。
UNASSIGNED：我们的研究表明，与欧洲人的左侧憩室病相比，憩室病是全结肠性的，并且更频繁地与更严重的出血相关。这种解剖学表现可能是由遗传背景而不是环境和饮食驱动的。
UNASSIGNED：我们进行了一项前瞻性对照研究，涉及法国下消化道出血（LGIH）的274例患者（中心1：瓜德罗普岛；中心2：LaRoche-sur-Yon）；179例憩室出血，其中AC组129例,E组40例.结肠探查包括使用专用内镜网格对憩室进行详细评估.
UNASSIGNED：AC和E在年龄方面具有相似的特征，性别,LGIH以前的历史，身体质量指数,饮食习惯，和药物，但AC在入院时的血流动力学参数明显较差，需要更多的输血(66.7%vs.42.5%；p=0.01）住院期间。在纳入研究的169名患者中，81%(N=137)(AC，n=106；E，n=31),并显示AC的右侧憩室病（占90.6%，包括在一个pancolonic形式的73.6%与35.5%；p=0.0002)和左侧憩室病(96.8%，分离形式在58.1%与9.4%,p=0.0002)。这些数据通过使用内窥镜网格对92例患者进行的敏感性分析得到证实，在AC中实现更高的频率和更大的憩室尺寸。
UNASSIGNED：我们的研究表明，与欧洲人的左侧憩室病相比，憩室病是全结肠性的，并且更频繁地与更严重的出血相关。这种解剖学表现可能是由遗传背景而不是环境和饮食驱动的。
