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Master Thesis

Évaluation du taux de prise en charge ambulatoire et de ses modalités concernant la suspicion de sigmoïdite aigüe non compliquée, en l'absence de scanner, en Aquitaine.

Abstract : Introduction: diverticulitis is a frequent pathology with a moderate complication rate. An abdominal and pelvic CT scan is essential to diagnose such complications, but is not always available in an ambulatory context. This study aimed to determine if suspected cases of uncomplicated diverticulitis were treated in ambulatory or sent to emergencies when a scan wasn’t available. Methodology: we studied retrospective practices amongst general practitioners from Aquitaine, based on their last case of suspected uncomplicated diverticulitis with no scan made in emergency. Results: we gathered 324 answers and excluded one. 301 patients (93%) were treated in ambulatory and 22 were sent to emergencies (7%) whose 15 (68%) to carry out a CT scan. Amongst patients in ambulatory, 263 (92%) received an antibiotic treatment, 184 (87%) were asked to follow a diet, and 268 (90%) had an early revaluation. 203 practitioners judged an emergency scan non essential, yet 118 performed it later. 98 practitioners were not able to obtain a CT scan exam in ambulatory. We observed a significative association between complications and sending to emergencies (p = 1,37e -8 ; OR = 36,62), and between absence of complications and antecedents of diverticulosis or diverticulitis (p = 9,30e -4 ; OR = 0,16). Our study also showed a positive association between such antecedents and the fact that practitioners did not prescribe a scan in emergency (p = 3,41e -3 ; OR = 2,2). Conclusion: official recommandations from the HAS advocate for carrying out an abdominal and pelvic CT scan for every outset of diverticulitis, but are not always applicable in real life. Practitioners adapt and treat patients in ambulatory. Further studies would help to determine risk factors associated with complications, and asses the utility of a CT scan exam for each recurrence.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03279717
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Tuesday, July 6, 2021 - 4:29:46 PM
Last modification on : Friday, July 9, 2021 - 3:48:02 AM

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  • HAL Id : dumas-03279717, version 1

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Paul Dufour, Fanny Mathieu. Évaluation du taux de prise en charge ambulatoire et de ses modalités concernant la suspicion de sigmoïdite aigüe non compliquée, en l'absence de scanner, en Aquitaine.. Médecine humaine et pathologie. 2021. ⟨dumas-03279717⟩

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