[Emergency surgical treatment of complicated acute diverticulitis].
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.
Bezzi
Marcello
M
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.
Lorusso
Riccardo
R
Forte
Angelo
A
Leonetti
Giovanni
G
Gallinaro
Luca Salvatore
LS
Urbano
Vincenzo
V
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