[Surgical treatment of colonic diverticulitis].
BACKGROUND
Colonic diverticulitis is a serious disease that may require surgical treatment. Early diagnosis and management are necessary to reduce the rates of morbidity-mortality.


OBJECTIVE
This review article was performed in order to discuss the most recent advances in the diagnosis and management of colonic diverticulitis.


RESULTS
Patients with acute diverticulitis should be categorized based upon the presence or absence of complications. Patients with complicated diverticulitis should be further categorized into I) pericolonic abscess, II) distant abscess (retroperitoneum or pelvis), III) purulent peritonitis, and IV) fecal peritonitis. In the absence of complications, elective treatment is mainly indicated in patients with recurrent episodes of diverticulitis. In complicated diverticulitis, the surgical alternatives will depend upon the clinical category. The current tendency is to attempt a percutaneous drainage of the abscess, followed by a semi-elective resection. In patients operated upon on emergency basis, resection with a diverting colostomy, with or without anastomosis, is the most widely used procedure.


CONCLUSIONS
Surgical treatment for acute diverticulitis should be based upon the presence of complications and their clinical category.
Peña Ruiz-Esparza
J P
JP
Servicio de Cirugía de Colon y Recto, Hospital de Especialidades, Instituto Mexicano del Seguro Social.
Maldonado-Medina
J
J
Vieyra-Antero
F
F
D018784:Abdominal Abscess / Q000209:etiology / Q000601:surgery; D000208:Acute Disease; D002481:Cellulitis / Q000209:etiology / Q000601:surgery; D004239:Diverticulitis, Colonic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004630:Emergencies; D006801:Humans; D010538:Peritonitis / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D014057:Tomography, X-Ray Computed