Diverticulitis of the colon in a community hospital

Summary

In our experience we have found that the incidence of hemorrhage in patients with diverticular disease is greater than that usually reported by others. We believe this is because patients who have acute or emergency conditions are more likely to go to community hospitals than to medical centers.

Of six patients who underwent surgical operations on account of hemorrhage, three had diverticulosis only and there was no evidence of inflammatory changes.

One-stage operations were performed in 20 of 44 recent patients. In 14, resections were performed in two or more stages (seven two-stage operations, five three-stage operations, and two Mikulicz resections). In ten cases the surgical procedures were limited to exploration or establishment of colostomies, or both.

The incidence of complications was high. In five patients fecal fistulas developed after one-stage resections. A patient who had wound dehiscence and another who had an obstruction of the small bowel survived after appropriate surgical treatment.

Primary one-stage operations were not performed in patients who had acute abcesses, massive pelvic inflammatory disease, peritonitis, or obstruction. Probably this accounts for the fact that only two patients (4.54 per cent) died.