Diverticulitis surgery: Difference between revisions
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**Diverticulitis complicated by intestinal obstruction | **Diverticulitis complicated by intestinal obstruction | ||
**Abscess formation and not responsive to the percutanous drainage | **Abscess formation and not responsive to the percutanous drainage | ||
***Enterocutaneous fistula formation | |||
==References== | ==References== | ||
Revision as of 18:05, 12 June 2017
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Diverticulitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Diverticulitis surgery On the Web |
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American Roentgen Ray Society Images of Diverticulitis surgery |
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Risk calculators and risk factors for Diverticulitis surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
If symptoms of diverticulitis are frequent, or the patient does not respond to antibiotics and resting the colon, the doctor may advise surgery. The surgeon removes the affected part of the colon and joins the remaining sections. This type of surgery—called colon resection—aims to prevent complications and future diverticulitis. The doctor may also recommend surgery for complications such as a fistula or partial intestinal obstruction.
Immediate surgery may be necessary when the patient has other complications, such as perforation, a large abscess, peritonitis, complete intestinal obstruction, or severe bleeding. In these cases, two surgeries may be needed because it is not safe to rejoin the colon right away. During the first surgery, the surgeon cleans the infected abdominal cavity, removes the portion of the affected colon, and performs a temporary colostomy, creating an opening, or stoma, in the abdomen. The end of the colon is connected to the opening to allow normal eating while healing occurs. Stool is collected in a pouch attached to the stoma. In the second surgery several months later, the surgeon rejoins the ends of the colon and closes the stoma.
Surgery
Surgical intervention in patients with diverticulitis is not the first line of treatment unlike the medical therapy in such patients. However, surgery is required in the complicated patients with diverticulitis who are unresponsive to the medical therapy and the conservative measures against the disease.
Emergency or urgent surgery
Emergency surgery is performed in life threatening cases of diverticulitis when it is complicated by perforation. Urgent surgery means operation that required to be done immediately in the same hospitalizaiton of the patient.[1][2]
- Indications of the urgent surgery:
- Diverticulitis complicated by peritonitis
- Patient becomes unresponsive to the medical treatment
- Diverticulitis complicated by intestinal obstruction
- Abscess formation and not responsive to the percutanous drainage
- Enterocutaneous fistula formation
References
- ↑ Sheth AA, Longo W, Floch MH (2008). "Diverticular disease and diverticulitis". Am J Gastroenterol. 103 (6): 1550–6. doi:10.1111/j.1572-0241.2008.01879.x. PMID 18479497.
- ↑ Wedell J, Banzhaf G, Chaoui R, Fischer R, Reichmann J (1997). "Surgical management of complicated colonic diverticulitis". Br J Surg. 84 (3): 380–3. PMID 9117315.