Rural Surgery pp 231-236 | Cite as




Diverticulosis is a very common finding in most western societies, which affects approximately 12% of the population and has an increasing incidence with age. Only 5% of patients with diverticulosis require surgical treatment for the disease. Computed tomography allows for reliable diagnosis in almost all cases of diverticulitis and assists with treatment decisions. Conservative treatment is based on intravenous antibiotics (2nd generation cephalosporin or ciprofloxacin plus metronidazole) and liquid/low residue diet. Emergency surgery is needed for patients with free perforation and diffuse peritonitis, whereas early elective surgery should be offered if conservative measures fail to control symptoms of pericolic abscess formation or covered perforations. Surgical options include laparoscopic and open resections with and without reconstruction of the gastrointestinal passage as well as with and without covering stoma formation depending on the clinical situation as well as the surgeons' preferences.

Recommended Reading

  1. Chapman, J., Davies, M., Wolff, B.: Complicated diverticulitis: is it time to rethink the rules? Ann. Surg. 242, 576–581 (2005)PubMedGoogle Scholar
  2. Constantinides, V.A., Tekkis, P.P., Athanasiou, T.: Primary resection with anastomosis vs. Hartmann’s procedure in nonselective surgery for acute colonic diverticulitis: a systemic review. Dis. Colon Rectum 49, 966–981 (2006)PubMedCrossRefGoogle Scholar
  3. Platell, C.: Critical evaluation: surgery for uncomplicated diverticulitis. ANZ J. Surg. 78, 96–98 (2008)PubMedCrossRefGoogle Scholar
  4. Rafferty, J., Shellito, P., Hyman, N.H., et al.: Practice parameters for sigmoid diverticulitis. Dis. Colon Rectum 49, 939–944 (2006)PubMedCrossRefGoogle Scholar
  5. Zorcolo, L., Covotta, L., Carlomagno, N., et al.: Toward lowering morbidity, mortality and stoma formation in emergency colorectal surgery: the role of specialisation. Dis. Colon Rectum 46, 1461–1467 (2003)PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Department of General SurgeryMount Gambier General Hospital and Flinders University Rural Medical SchoolMount GambierAustralia
  2. 2.Department of SurgeryUniversity Hospital GrosshadernMunichGermany

Personalised recommendations