Skip to main content
Log in

Surgical treatment of perforated diverticulitis of the sigmoid colon

  • Published:
Diseases of the Colon & Rectum

Abstract

A retrospective review of 1353 cases of acute perforated sigmoid diverticulitis treated surgically demonstrates that those operations that resect or exteriorize the perforated segment at the first operation are associated with a lower operative mortality rate than procedures that fail to remove the perforated segment at the initial operation. These results are true for both diffuse peritonitis and localized abscess.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Rodkey GV, Welch CE. Colonic diverticular disease with surgical treatment: a study of 338 cases. Surg Clin North Am 1974;54:655–74.

    PubMed  CAS  Google Scholar 

  2. Goligher JC. Surgery of the anus, rectum, and colon. 3rd ed. London: Bailliere Tindall. 1975: 1076–1115.

    Google Scholar 

  3. Hughes ES, Cuthbertson AM, Carden AB. The surgical management of acute diverticulitis. Med J Aust 1963;1:780–2.

    Google Scholar 

  4. Hinchey EJ, Schaal PG, Richards GK. Treatment of perforated diverticular disease of the colon. Adv Surg 1978; 12: 85–109.

    PubMed  CAS  Google Scholar 

  5. Morgenstern L, Weiner R, Michel SL. ‘Malignant’ diverticulitis: a clinical entity. Arch Surg 1979; 114: 1112–6.

    PubMed  CAS  Google Scholar 

  6. Nunes GC, Robnett AH, Kremer RM, Ahlquist RE Jr. The Hartmann procedure for complications of diverticulitis. Arch Surg 1979; 114: 425–9.

    PubMed  CAS  Google Scholar 

  7. Sweatman CA Jr, Aldrete JS. The surgical management of diverticular disease of the colon complicated by perforation. Surg Gynecol Obstet 1977; 144: 47–50.

    PubMed  Google Scholar 

  8. Himal HS, Ashby DB, Duignan JP, Richardson DM, Miller JL, MacLean LD. Management of perforated diverticulitis of the colon. Surg Gynecol Obstet 1977; 144: 225–6.

    PubMed  CAS  Google Scholar 

  9. Berardi RS, Siroospour D. Diverticular disorders of the colon: results of treatment in 128 patients. Int Surg 1976; 61: 490–3.

    PubMed  CAS  Google Scholar 

  10. Laimon H. Hartmann resection for acute diverticulitis. Rev Surg 1974; 31: 1–6.

    PubMed  CAS  Google Scholar 

  11. Labow SB, Salvati EP, Rubin RJ. The Hartmann procedure in the treatment of diverticular disease. Dis Colon Rectum 1973; 16: 392–4.

    Article  PubMed  CAS  Google Scholar 

  12. Miller DW Jr, Wichern WA Jr. Perforated sigmoid diverticulitis: appraisal of primary versus delayed resection. Am J Surg 1971; 121: 536–40.

    Article  PubMed  Google Scholar 

  13. Byrne JJ, Garick EI. Surgical treatment of diverticulitis. Am J Surg 1971; 121: 379–84.

    Article  PubMed  CAS  Google Scholar 

  14. Garnjobst W, Hardwick C. Further criteria for anastomosis in diverticulitis of the sigmoid colon. Am J Surg 1970;120:264–9.

    Article  PubMed  CAS  Google Scholar 

  15. Moore HD. Emergency treatment of diverticulitis of the sigmoid flexure. Dis Colon Rectum 1969; 12: 22–5.

    Article  PubMed  CAS  Google Scholar 

  16. Giffin JM, Butcher HR Jr, Ackerman LV. Surgical management of colonic diverticulitis. Arch Surg 1967; 94: 619–26.

    PubMed  CAS  Google Scholar 

  17. Localio SA, Stahl WM. Diverticular disease of the alimentary tract. Part I: The colon. Chicago: Year Book Medical Publishers, Inc. 1967 Dec: 3–78.

    Google Scholar 

  18. Byrne RV. Primary resection of the colon for perforated diverticulum. Am J Surg 1966; 112: 273–8.

    Article  PubMed  CAS  Google Scholar 

  19. Bacon HE, Pezzutti JE. Adequate resection for diverticulitis of the colon. Arch Surg 1966;92:58–9.

    PubMed  CAS  Google Scholar 

  20. Madden JL. Primary resection and anastomosis in the treatment of perforated lesions of the colon. Am Surg 1965; 31: 781–6.

    PubMed  CAS  Google Scholar 

  21. Smithwick RH. Surgical treatment of diverticulitis of the sigmoid. Am J Surg 1960; 99: 192–205.

    Article  PubMed  CAS  Google Scholar 

  22. Howe HJ, Casali RE, Westbrook KC, Thompson BW, Read RC. Acute perforations of the sigmoid colon secondary to diverticulitis. Am J Surg 1979; 137: 184–7.

    Article  PubMed  CAS  Google Scholar 

  23. Eng K, Ranson JH, Localio SA. Resection of the perforated segment: a significant advance in treatment of diverticulitis with free perforation or abscess. Am J Surg 1977; 133: 67–72.

    Article  PubMed  CAS  Google Scholar 

  24. Nahrwold DL, Demuth WE. Diverticulitis with perforation into the peritoneal cavity. Ann Surg 1977; 185: 80–3.

    Article  PubMed  CAS  Google Scholar 

  25. Endrey-Walder P, Judd ES. Acute perforating diverticulitis: emergency surgical treatment. Minn Med 1973; 56: 27–30.

    PubMed  CAS  Google Scholar 

  26. Tagart RE. General peritonitis and haemorrhage complicating colonic diverticular disease. Ann R Coll Surg Engl 1974; 55: 175–83.

    PubMed  CAS  Google Scholar 

  27. Watkins GL, Oliver GA. Surgical treatment of acute perforative diverticulitis. Surgery 1971; 69: 215–9.

    PubMed  CAS  Google Scholar 

  28. Whelan CS, Furcinitti JF, Laverreda C. Surgical management of perforated lesions of the colon with diffusing peritonitis. Am J Surg 1971; 121: 374–8.

    Article  PubMed  CAS  Google Scholar 

  29. Roxburgh RA. Immediate resection of acute diverticulitis. Proc R Soc Med 1970; 63 (suppl): 52–5.

    PubMed  Google Scholar 

  30. Killingback MJ. Acute diverticulitis: progress report. Australasian survey (1967–1969). Dis Colon Rectum 1970;13:444–7.

    Article  PubMed  CAS  Google Scholar 

  31. Fenger C, Nyholm K, Amdrup E. Diverticulitis of the colon. Acta Chir Scand 1969; suppl 396: 114–20.

    Google Scholar 

  32. Smiley DF. Perforated sigmoid diverticulitis with spreading peritonitis. Am J Surg 1966; 111: 431–4.

    Article  PubMed  CAS  Google Scholar 

  33. Dawson JL, Hanon I, Rosburgh RA. Diverticulitis coli complicated by diffuse peritonitis. Br J Surg 1965; 52: 354–7.

    Article  PubMed  CAS  Google Scholar 

  34. Aronson AR, Miller JW, Honig JL, Altman KA. Generalized peritonitis complicating acute diverticulitis of colon. NY State J Med 1965; 65: 437–41.

    CAS  Google Scholar 

  35. Large JM. Treatment of perforated diverticulitis. Lancet 1964; 1: 413–4.

    Article  PubMed  CAS  Google Scholar 

  36. Hartley RC. Dangers of diverticulitis coli: an estimation of the place of resection in avoidance of complications. Br J Surg 1964; 51: 45–9.

    Article  PubMed  CAS  Google Scholar 

  37. Staunton MD. Treatment of perforated diverticulitis coli. Br Med J 1962; 1: 916–8.

    Article  PubMed  CAS  Google Scholar 

  38. Ryan P. Emergency resection and anastomosis for perforated sigmoid diverticulitis. Br J Surg 1958; 45: 611–6.

    Article  PubMed  CAS  Google Scholar 

  39. Belding HH III. Acute perforated diverticulitis of the sigmoid colon with generalized peritonitis. Arch Surg 1957; 74: 511–5.

    Google Scholar 

  40. MacLaren IF. Perforated diverticulitis: a survey of 75 cases. J Roy Coll Surg Edinb 1957; 3: 129–44.

    PubMed  CAS  Google Scholar 

  41. Hughes LE. Postmortem survey of diverticular disease of the colon. Part I. Diverticulosis and diverticulitis. Part II. The muscular abnormality in the sigmoid colon. Gut 1969; 10: 336–51.

    Article  PubMed  CAS  Google Scholar 

  42. Parks TG. Post-mortem studies on the colon with special reference to diverticular disease. Proc R Soc Med 1968; 61: 932–4.

    PubMed  CAS  Google Scholar 

  43. Ackerman LV, Rosal J. Surgical pathology. 5th ed. St. Louis: Mosby 1974: 441–5.

    Google Scholar 

  44. Morson BC. The muscle abnormality in diverticular disease of the colon. Proc R Soc Med 1963; 56: 798–800.

    PubMed  CAS  Google Scholar 

  45. Painter NS. Colonic diverticular disease: Miller’s bran in management (symposium). Dis Colon Rectum 1975: 18: 549–54.

    Article  PubMed  Google Scholar 

  46. Brodribb AJ. Treatment of symptomatic diverticular disease with a high-fibre diet. Lancet 1977; 1: 664–6.

    Article  PubMed  CAS  Google Scholar 

  47. Parks TG. Natural history of diverticular disease of the colon: a review of 521 cases. Br Med J 1969; 4: 639–42.

    PubMed  CAS  Google Scholar 

  48. Smithwick RH. Experience with surgical management of diverticulitis of the sigmoid. Ann Surg 1942; 115: 969–85.

    Article  PubMed  CAS  Google Scholar 

  49. McSherry CK, Grafe WR Jr, Perry HS, Glenn F. Surgery of the large bowel for emergent conditions: staged vs primary resection. Arch Surg 1969; 98: 749–53.

    PubMed  CAS  Google Scholar 

  50. Cheever D. The choice of operation in carcinoma of the colon. Ann Surg 1931; 94: 705–16.

    Article  PubMed  CAS  Google Scholar 

  51. Classen JN, Bonardi R, O’Mara CS, Finney DC, Sterioff S. Surgical treatment of acute diverticulitis by staged procedures. Ann Surg 1976; 184: 582–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Read at the meeting of the New York Society for Colon and Rectal Surgery, New York, New York, March 20 1980.

About this article

Cite this article

Greif, J.M., Fried, G. & McSherry, C.K. Surgical treatment of perforated diverticulitis of the sigmoid colon. Dis Colon Rectum 23, 483–487 (1980). https://doi.org/10.1007/BF02987083

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02987083

Key words

Navigation