title: [Current concepts of perforated sigmoid diverticulitis].
abstract: Despite modern therapeutical options,perforated sigma diverticulitis still represents a life-threatening disease. In terms of diagnostic and therapeutic proceeding, the covered perforation has to be distinguished from free perforation.Primary therapeutic objective is the excision of the inflamed bowel segment to avoid abdominal sepsis.Therapeutic options for covered perforation include conservative treatment with or without placement of interventional drains. A free perforated diverticulitis implies the resection of the perforated bowel segment. Primary anastomosis should be aspired. In advanced cases, Hartmann procedure may be required. Individual decision making should be based on individual risk profile, on peritonitis severity score and on surgeon experience. In a two stage procedure, relevant morbidity of the second operation has to be considered.Recently suggested approaches,laparoscopic lavage or interventional drainage without resection, remain a matter of debate.
authors: Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Kantonsspital Baden.
authors: Alexandre
authors: A
authors: Descloux
authors: Markus
authors: M
authors: Doß
authors: Andreas
authors: A
authors: Keerl
authors: Thomas
authors: T
authors: Kocher
authors: Robert
authors: R
authors: Rosenberg
mesh_terms: D018784:Abdominal Abscess / Q000175:diagnosis / Q000601:surgery; D000714:Anastomosis, Surgical; D004239:Diverticulitis, Colonic / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D004630:Emergencies; D006801:Humans; D007081:Ileostomy; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D010535:Laparoscopy; D010533:Peritoneal Lavage; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D012810:Sigmoid Diseases / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D014057:Tomography, X-Ray Computed