[Perforated diverticulitis of the colon. Problems of diagnosis and surgical tactics].
Perforated diverticulitis of the large bowel is a frequent observation in surgical practice. There is, however, no standard attitude to the procedures to be adopted: the only fixed point is the abandonment of straightforward colostomy and drainage. A series of 16 cases of perforated diverticulitis of the large bowel operated on in emergency and treated with various procedures, i.e. 8 Hartmann resections, 6 Paul-Mikulicz operations, 2 ideal colectomies, 2 colostomies and drainage. The observations made permit a number of considerations: 1) "ideal colectomy" is undoubtedly the best intervention providing the patient presents an early NPT and a temporary colostomy has been made to protect the anastomosis; 2) the rupture of a single diverticulum suggests the Paul-Mikulicz operation and it can be treated at a later stage by straightforward closure; 3) rupture of a diverticulum within the framework of extended diverticular involvement suggests Hartmann's resection; 4) colostomy and drainage should be abolished for its poor results and can be kept for patients in very serious condition.
Balducci
D
D
Pancaldi
R
R
Borgo
G
G
Chiodaroli
R
R
Procino
M
M
Postiglione
V
V
Bruni
G C
GC
D000368:Aged; D000369:Aged, 80 and over; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008722:Methods; D008875:Middle Aged
Diverticolite perforata del colon. Problemi di diagnosi e di tattica chirurgica.