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PubMed1979

[Colonic diverticulitis and appendicitis].

A retrospective analysis of the clinical data has shown that a complicated diverticulitis can often simulate the clinical picture of acute appendicitis. The methods of diagnosis and surgery of the complicated diverticulum are recommended in which the operations in many steps (extraperitonization, colostomy, cecostomy, resection) are considered to be preferable.

Acute Disease↗
PubMedDate not supplied

[Complications of colonic diverticulitis [apropos of 22 cases)].

After establishing the nosologic frame of the notions of diverticulosis, diverticulitis and the complications of the latter the authors make an analysis of 22 cases with complications of colic diverticulitis, and stress the frequency of this complication in the aged. Ten of the complication consisted in haemorrhagia, 8 were perforations and 4 were obstructive. The authors establish the attitude which should be adopted when confronted with confirmed diverticulitis, and make an analysis of each type of complication from the viewpoint of the diagnosis and of the therapeutic attitude. In haemorrhagic complications surgical intervention is rarely necessary (one out of the 10 cases recorded), surgery is however mandatory in the obstructive and perforating complications. The authors prefer the Hartmann type of intervention considering the risks of anastomosis in conditions which are generally doubtful at the best, due to advanced age of patients and associated deficiencies. Beside the analysis this paper also updates the major elements of the problem, as shown by the references.

Aged↗
PubMed1984

The management of acute colonic diverticulitis with suppurative peritonitis.

With improvement in the medical management of diverticular disease, perforation has become the most common indication for surgical intervention. It is a source of considerable morbidity and mortality and consequently has provoked a considerable and controversial challenge for surgeons. We are proposing that all patients found to have purulent peritonitis secondary to perforating diverticulitis at laparatomy, should be managed initially by a defunctioning transverse colostomy, drainage and the administration of appropriate antibiotics. Subsequent management should consist of simple closure of the colostomy following a check barium enema and the commencement of a high fibre diet. We substantiate this by reporting 20 cases from Dudley Road Hospital and 20 others mentioned in the current literature.

Acute Disease↗
PubMed1994

[Current trends in the treatment of perforated colonic diverticulitis].

The authors, after having examined the cases of complicated diverticulitis operated between 1985 and 1993, confirm that the surgical treatment for this particular pathology is strictly dependent on the local or general seriousness. In the light of this they consider an operation for resection and anastomosis 1st stage justifiable only in selected cases; colostomy and drainage in particularly serious cases, preferring Hartmann's method of operation for the 3rd and 4th stages of Chappuis and Chon. The results obtained agree in a satisfactory manner with the data in the literature.

Aged↗