Complicated forms of colon diverticulosis – clinical presentation, diagnosis, treatment strategy
DOI:
https://doi.org/10.5281/zenodo.15257324Keywords:
colon diverticulosis, diverticulitis, peritonitisAbstract
INTRODUCTION. Colon diverticulosis is a common disease with a pronounced socially significant effect. The disease affects about 1/3 of people of working age (10% are about 40-yearold), and the other affected 2/3 (50-70%) are over 75 years old.Possible complications of diverticulosis are diverticulitis with bleeding, abscess formation, perforation with purulent or feculent peritonitis, stenosis of the colon, and fistulation to adjacent and underlying organs.
Aim. The aim of the present study is to analyze the clinical presentation, diagnostic and therapeutic steps and surgical strategies for the specific complications of colonic diverticulosis.
MATERIALS AND METHODS. A retrospective analysis of cases with complicated forms of colorectal diverticulosis admitted and treated at the Department of Liver and Pancreatic Surgery, First Surgical Clinic of University Hospital "Dr. G. Stranski" was made for the period 2012-2021. The hospital's Gamma code master database and operative and histological logs were used as a source of data.
RESULTS. One hundred and twenty seven patients with complicated diverticulosis were hospitalizedin the Clinic during the study period. There were 41 (32.3%) patients with bleeding, 74 (58.3%) with ileus/subileus picture, and 12 (9.4%) with perforation or abscess. The following surgical interventions were applied: sigmoid resection with end-to-end anastomosis - 19 (37.2%), Hartmann's operation - 12 (23.5%), left hemicolectomy with end-to-end anastomosis - 11 (21.6%) , right hemicolectomy with lateralto-lateral anastomosis – 3 (5.9%), transverse colonic resection – 6 (11.7%). Early postoperative mortality was 3.1%.
CONCLUSION. Surgical treatment of complicated colorectal diverticulosis is a significant problem in modern coloproctology, and the interdisciplinary approach of gastroenterologists, surgeons and anesthesiologists plays a role in the successful end of the treatment. The selection of a specific surgicalprocedure must be consistent with the data on the stage of the complication, its type and severity, and on the other hand, with the individual characteristics of the patient – age, comorbidity and reactivity.
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