Treatment of perforated diverticulitis with generalized peritonitis: past, present, and future.
BACKGROUND
The supposed optimal treatment of perforated diverticulitis with generalized peritonitis has changed several times during the last century, but at present is still unclear.


RESULTS
The first cases of complicated perforated diverticulitis of the colon were reported in the beginning of the twentieth century. At that time the first therapeutic guidelines were postulated in which an initial nonresectional procedure was provided to be the safest plan of management. After many years in which resection had become standard practice, today, one century later, again (laparoscopic) nonresectional surgery is presented as a safe and promising alternative in treatment of complicated perforated diverticulitis. The question rises what had happened to close the circle?


CONCLUSIONS
This paper includes a historic summary of changing patterns in surgical strategies in perforated diverticulitis complicated by generalized peritonitis.
Vermeulen
Jefrey
J
Department of Colorectal Surgery, Erasmus Medical Center, Dr Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. j.vermeulen.1@erasmusmc.nl
Lange
Johan F
JF
D000714:Anastomosis, Surgical / Q000379:methods; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003106:Colon / Q000601:surgery; D004239:Diverticulitis, Colonic / Q000150:complications / Q000601:surgery*; D004322:Drainage; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D010538:Peritonitis / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy; D018805:Sepsis / Q000188:drug therapy; D007507:Therapeutic Irrigation / Q000379:methods*
D000900:Anti-Bacterial Agents