title: [Emergency surgical treatment of complicated acute diverticulitis].
abstract: Twenty-five percent of patients undergoing surgery for acute complicated diverticulitis represent emergencies. This condition is currently treated by colonic resection with primary anastomosis with or without colostomy, or by a Hartmann operation. We report on our experience with 52 consecutive patients with generalized peritonitis (8 cases), peri- and paracolonic abscesses (19 cases), severe pelvic abscesses (12 cases) and multiple abscesses with visceral fistulas (13 cases). All patients had emergency surgery. In 50/52 patients (96.2%) we performed a colonic resection with primary anastomosis using a mechanical stapler and in 2/52 a Hartmann operation. The overall mortality rate was 5.8%. The morbidity rate was 22% with 9 anastomotic leakages. A diverting colostomy was constructed in 16 patients and opened in only 8 patients. In 4 cases a parastomal hernia occurred after late closure and reduction of the colostomy. This data suggest that colonic resection with primary anastomosis, even without colostomy, is a safe procedure for the emergency treatment of acute complicated diverticulitis.
authors.affiliation: S.S. Chirurgia Laparoscopica e Mininvasiva Dipartimento di Scienze Chirurgiche e Technologie Mediche Applicate, Università degli Studi di Roma La Sapienza Policlinico Umberto I, Roma.
authors.forename: Marcello
authors.initials: M
authors.lastname: Bezzi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Lorusso
authors.forename: Angelo
authors.initials: A
authors.lastname: Forte
authors.forename: Giovanni
authors.initials: G
authors.lastname: Leonetti
authors.forename: Luca Salvatore
authors.initials: LS
authors.lastname: Gallinaro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Urbano
mesh_terms: D000208:Acute Disease; D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000379:methods; D003106:Colon / Q000601:surgery; D004239:Diverticulitis, Colonic / Q000150:complications / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies