Complicated sigmoid diverticulosis.
BACKGROUND
To evaluate the outcome of patients treated for complications of sigmoid diverticular disease.


METHODS
Fifteen patients (11 women; aged 54-80 years) were treated over a 6-year period in a community hospital. Five patients presented with perforation and peritonitis, 3 with colovesical fistula, 2 with colovaginal fistula, 2 with recurrent phlegmon and 3 with bleeding. Six patients (5 with perforation, 1 colovesical fistula with hematuria) underwent emergency surgery. Six patients (2 with colovesical fistula, 2 colovaginal fistula and 2 recurrent phlegmon) underwent planned sigmoid resection. All 3 patients with bleeding were treated conservatively.


RESULTS
One patient with a colovesical fistula and severe hematuria died 72 hours later with septicemia. All 5 patients with peritonitis survived; two had an eventful post-operative period and were in hospital for nearly 3 months. All 5 developed wound sepsis. Six patients who had a planned procedure had uneventful recovery. The 3 patients who presented with bleeding recovered.


CONCLUSIONS
Complicated diverticular disease carries a high morbidity and mortality especially when operated on as an emergency. Interval sigmoid resection should be offered to patients who have recovered from an acute complication.
Balsara
K P
KP
Department of Surgery, Parsee General Hospital, Mumbai.
Dubash
C
C
D000368:Aged; D000369:Aged, 80 and over; D002481:Cellulitis / Q000209:etiology / Q000601:surgery; D004241:Diverticulum, Colon / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications; D012810:Sigmoid Diseases / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome