Emergency surgery for complicated diverticular disease

Abstract text (incl. references and figure legends)

Introduction: Complicated diverticular disease of the colon is a disabling disease and an important cause of hospital admissions. Acute colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in the acute setting. Surgery can be considered a therapeutic option for these patients.

Material & Methods: Single center retrospective study that included all the patients who were submitted to emergency surgery because of complicated diverticular disease, from 2016 to 2020. Data recorded included baseline demographics, indication for surgery, operative details, length of hospital stay and complications.

Results: This study included 27 patients, 83% males, with a median age of 56 years. 30% had known diverticular disease, most of them with previous hospital admissions. The main presenting symptom was abdominal pain. One patient was admitted for acute diverticular hemorrhage and the others for acute complicated diverticulitis (35% Hinchey III and IV). 41% of the patients underwent a colonic resection (44% Hartman procedure) and 50% were submitted to laparoscopic peritoneal lavage. The median pos-operative length was 10 days. 26% of the patients had post-operative complications – 4% had anastomosis dehiscence and 22% had wound infection. The mortality rate was 0%. 30% of the patients had other episodes of diverticulitis after hospital discharge.

Conclusions: Complicated diverticular disease carries significant mortality and morbidity. Identification and prompt treatment of high-risk patients are important to reduce mortality and morbidity. Surgery still plays an important role for Hinchey II-IV patients.

References: Köckerling F.: Emergency Surgery for Acute Complicated Diverticulitis. Viszeralmedizin 2015; 31(2). Sartelli, M., et al. 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting. World J Emerg Surg 15, 32 (2020).

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