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Session:: ePosters-Sun800-M8: Benign Abdominal

EP335 - Does presence of fistula impact postoperative outcomes in patients undergoing surgery for diverticulitis?

Sunday, May 10, 2026
8:32 AM - 8:37 AM ET

    ePoster Presenter(s)

  • Alyssa Habermann, MD (she/her/hers)

    General Surgery Resident
    Virginia Commonwealth University
    Virginia Commonwealth University
    Richmond, VA, United States

    Disclosure information not submitted.

    View ePoster

    • Author(s)

  • BF

    Beshoy Fahmy, MD

    Fellow
    Virginia Commonwealth University
    Richmond, Virginia, United States

    Disclosure information not submitted.

  • Jaime Bohl, MD

    Professor
    Virginia Commonwealth University
    Richmond, Virginia, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Nicole Wieghard, MD, FACS, FASCRS (she/her/hers)

    Associate Professor of Surgery
    Virginia Commonwealth University
    Virginia Commonwealth University
    Richmond, VA, United States

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

Purpose/Background: Diverticulitis is one of the most common indications for colectomy. Fistulizing diverticulitis, occurring in approximately 2-5% of patients, represents a more advanced and chronic inflammatory process. Several studies have evaluated risks factors associated with increased rate of complications including obesity, smoking, emergent surgery, and open surgery. However, it remains unclear whether the presence of a fistula increases the risk of postoperative infections. We aim to evaluate the presence of a fistula as an independent risk factor for postoperative morbidity in patients with diverticulitis.

Methods/Interventions: The NSQIP database from 2005-2022 was queried for all patients who underwent surgery for diverticulitis. These patients were then separated into groups based on presence of fistula and fistula type (vesicular, vaginal, cutaneous, or enteric/colonic/rectal) using CPT codes. Operative outcomes regarding surgical site infection (SSI), wound complication, infectious complications, readmission, reparation, and conversion to open were compared between each type of fistula and no fistula using binomial regression. Total hospital length of stay (HLOS) between groups was compared using ANOVA.

Results/Outcomes: Patients with vesicular fistula have a higher likelihood of superficial SSI (OR 1.34 [1.03, 1.75]), UTI (OR 2.31 [1.64, 3.24]), sepsis (OR 1.43 [1.05, 1.94]), and conversion to open (OR 3.08 [1.55, 6.10]) compared to the no fistula group. Patients with vaginal fistula have a higher likelihood of superficial SSI (OR 1.64 [1.01, 2.68]) compared to the no fistula group. Patients with cutaneous fistula have a higher likelihood of organ space SSI (OR 2.10 [1.02, 4.34]) compared to the no fistula group. Patients with enteric/colonic fistula have higher likelihood of wound dehiscence (OR 2.91 [1.29, 6.60]) compared to the no fistula group. Patients with cutaneous fistula have a higher mean HLOS (9.19 days) compared to the no fistula group (6.75 days), (p=0.04).

Conclusion/Discussion: Presence of fistula in patients who undergo surgery for diverticulitis is associated with increased risk of superficial and organ space SSI, wound dehiscence, UTI, sepsis, and conversion to open.Table 1
Operative outcomes of patients who underwent surgery for diverticulitis with various types of fistula compared to those without fistula (reference group). Binomial regression was used to compute odds ratio with 95% confidence interval. Significance was set as p<0.05. Significant values are in bold. Variables with insufficient sample size to determine odds ratio are left blank.
Table 2
Total hospital length of stay after surgery for diverticulitis with or without fistula. ANOVA was used to compare mean length of stay between no fistula and each type of fistula. Significance was set at p<0.05. Significant values are in bold.