Scientific Online Resource System

Scripta Scientifica Medica

Complicated Colonic Diverticulosis. Diagnostic And Therapeutic Strategy

Plamen Chernopolsky, Vassil Bozhkov, Dilyan Chaushev, Rossen Madjov

Abstract

Rarely diagnosed before the twentieth century, complicated diverticulosis is the most common surgically treated colon disease after colorectal cancer in Western countries.

A retrospective analysis of 213 patients with colonic diverticulosis was performed. Of them, 94 were male and 109 were female. Their mean age was 60.9 (32–91); 10% were under 50; 33% were aged 50–60; 42% were aged 60–80; and 15% were over 80.

We analyzed demographics, severity of disease, surgical outcomes: time to intervention, recovery passage, feeding, length of hospitalization, complications, reinterventions, and lethality.

Diverticulitis is classified as complicated or uncomplicated based on: CT data, medical history, the severity of clinical symptoms, and diagnostic imaging data.


Keywords

diverticulitis, complications, surgery, outcome

Full Text


References

Nguyen GC, Sam J, Anand N. Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States. World J Gastroenterol. 2011;17(12):1600-5. doi: 10.3748/wjg.v17.i12.1600.

Parks TG. Natural history of diverticular disease of the colon. A review of 521 cases. Br Med J. 1969;4(5684):639-42. doi: 10.1136/bmj.4.5684.639.

Hinchey EJ, Schaal PG, Richards GK. Treatment of perforated diverticular disease of the colon. Adv Surg. 1978;12:85-109.

Wasvary H, Turfah F, Kadro O, Beauregard W. Same hospitalization resection for acute diverticulitis. Am Surg. 1999;65(7):632-5; discussion 636.

Jacobs DO. Clinical practice. Diverticulitis. N Engl J Med. 2007;357(20):2057-66. doi: 10.1056/NEJMcp073228.

Garber A, Hyman N, Osler T. Complications of Hartmann takedown in a decade of preferred primary anastomosis. Am J Surg. 2014;207(1):60-4. doi: 10.1016/j.amjsurg.2013.05.006.

Gawlick U, Nirula R. Resection and primary anastomosis with proximal diversion instead of Hartmann's: evolving the management of diverticulitis using NSQIP data. J Trauma Acute Care Surg. 2012;72(4):807-14; quiz 1124. doi: 10.1097/TA.0b013e31824ef90b.

Murray JJ, Schoetz DJ Jr, Coller JA, Roberts PL, Veidenheimer MC. Intraoperative colonic lavage and primary anastomosis in nonelective colon resection. Dis Colon Rectum. 1991;34(7):527-31. doi: 10.1007/BF02049889.

Franklin ME Jr, Portillo G, Treviño JM, Gonzalez JJ, Glass JL. Long-term experience with the laparoscopic approach to perforated diverticulitis plus generalized peritonitis. World J Surg. 2008;32(7):1507-11. doi: 10.1007/s00268-007-9463-y.

Afshar S, Kurer MA. Laparoscopic peritoneal lavage for perforated sigmoid diverticulitis. Colorectal Dis. 2012;14(2):135-42. doi: 10.1111/j.1463-1318.2011.02606.x.

Myers E, Hurley M, O'Sullivan GC, Kavanagh D, Wilson I, Winter DC. Laparoscopic peritoneal lavage for generalized peritonitis due to perforated diverticulitis. Br J Surg. 2008 Jan;95(1):97-101. doi: 10.1002/bjs.6024.

Rogers AC, Collins D, O'Sullivan GC, Winter DC. Laparoscopic lavage for perforated diverticulitis: a population analysis. Dis Colon Rectum. 2012 Sep;55(9):932-8. doi: 10.1097/DCR.0b013e31826178d0.

Stewart J, Diament RH, Brennan TG. Management of obstructing lesions of the left colon by resection, on-table lavage, and primary anastomosis. Surgery. 1993;114(3):502-5.

Klarenbeek BR, de Korte N, van der Peet DL, Cuesta MA. Review of current classifications for diverticular disease and a translation into clinical practice. Int J Colorectal Dis. 2012;27(2):207-14. doi: 10.1007/s00384-011-1314-5.




DOI: http://dx.doi.org/10.14748/ssm.v55i0.9263
Array
Article Tools
Email this article (Login required)
About The Authors

Plamen Chernopolsky
Second Department of Surgery, St. Marina University Hospital, Medical University of Varna

Vassil Bozhkov
Second Department of Surgery, St. Marina University Hospital, Medical University of Varna

Dilyan Chaushev
Second Department of Surgery, St. Marina University Hospital, Medical University of Varna

Rossen Madjov
Second Department of Surgery, St. Marina University Hospital, Medical University of Varna

Font Size


|