Extraperitoneal manifestation of perforated diverticulitis.
We observed five cases of unusual extraperitoneal presentation of diverticulitis during an 11 year period. During that time, a total of 263 patients were operated for diverticulitis. Patients 1-4 presented with an inflammatory spread of diverticulitis through the abdominal wall; in patient 5 multiple abscesses were present in the left thigh. Inadequate resection and previous radiotherapy in patient 4 might have contributed to the complicated course. In patient 5, poor condition initially allowed only local drainage of the thigh abscesses. Despite laparotomy and sigmoid resection a few days after drainage, the fatal outcome could not be prevented. A more extensive resection and a protecting colostomy might have prevented the fistulous complication in patient 4. A primary resection and abscess drainage might have averted the fatal outcome in patient 5.
Rothenbuehler
J M
JM
Department of Surgery, University Hospital Basle, Switzerland.
Oertli
D
D
Harder
F
F
D000009:Abdominal Muscles; D000038:Abscess / Q000209:etiology* / Q000382:microbiology; D000368:Aged; D017577:Cutaneous Fistula / Q000209:etiology*; D004239:Diverticulitis, Colonic / Q000150:complications*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D007416:Intestinal Perforation / Q000209:etiology*; D012810:Sigmoid Diseases / Q000150:complications*; D013848:Thigh