Characteristics of Abdominal Fluid in Patients With Diverticulitis Hinchey III or IV

Study Overview
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Brief Summary
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Perforated diverticulitis of the colon can be complicated by peritonitis, either purulent or fecal. Both are life threatening conditions requiring emergency surgery. The background in terms of reasons for inflammation (diverticulitis) and perforation to develop is unknown. In this study we focus on specific changes associated with inflammation, both in tissues and of fecal and mucosal microbiota.

Detailed Description
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A prospective study of abdominal fluid, periferal blood, tissues as well as feces in Patients (perforated diverticulitis with peritonitis undergoing emergency surgery, Group I), and in Controls (patients operated due to colorectal cancer, Group II; patients with mild diverticulitis not needing surgery, Group III). Immune acitvity in abdominal fluid and periferal blood by immunoassay of 92 individual proteins. mRNA expression of 96 specific genes in tissue samples. Quatification of bacterial diversity in feces and colon mucosa.

Official Title
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Study of Changes in Abdominal Fluid in Connection With Peritonitis. A Descriptive Study in Patients With Purulent or Fecal Peritonitis.

Conditions
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Perforated Diverticulitis

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Signs of perforated diverticulitis with peritonitis and decision to perform emergency surgery (Group I) Signs of acute diverticulitis and no decision of emergency surgery (Group II) Patients with colorectal cancer planned for elective surgery (Group III) Exclusion Criteria: No surgery performed (Group I and III) Withdrawn consent (any group)
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group I<br>Patients undergoing emergency surgery due to perforated diverticulitis with peritonitis. No intervention, samples from abdominal fluid, blood, tissue, feces | |
| Group II<br>Patients with colorectal cancer undergoing elective surgery. No intervention. Samples as for Group I | |
| Group III<br>Patients with mild diverticulitis, not undergoing surgery. No intervention. Samples from blood and feces. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| inflammatory response | determination of levels of 92 proteins in abdominal fluid and blood | index surgery (Groups I and II)/ emergency room (Group III) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| inflammatory response in tissue | RNA sequencing (96 spcific genes) in abdominal tissue | index surgery (Groups I and II)/ emergency room (Group III) | 
| microbiota composition | PCR amplification, cloning and sequencing of genes | index surgery (Groups I and II)/ emergency room (Group III) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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perforated diverticulitis, peritonitis, protein changes, microbiota