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Complicated diverticulosis.

P B Boulos1

  • 1Department of Surgery, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK.

Best Practice & Research. Clinical Gastroenterology
|October 31, 2002
PubMed
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Early diagnosis and treatment of diverticulitis prevent complications. Computer tomography (CT) scanning aids diagnosis and abscess drainage, improving outcomes and avoiding emergency surgery in most cases.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Diagnostic Imaging

Background:

  • Diverticulitis can progress from uncomplicated to complicated forms, including abscess, perforation, fistula, and obstruction.
  • Early medical intervention is crucial to prevent disease progression.

Purpose of the Study:

  • To highlight the importance of early diagnosis and treatment in preventing complicated diverticulitis.
  • To discuss the role of diagnostic imaging and interventional procedures in managing diverticulitis.

Main Methods:

  • Review of diagnostic modalities, emphasizing Computer Tomography (CT) scanning.
  • Discussion of interventional radiology for percutaneous drainage of abscesses.
  • Analysis of surgical approaches for complicated diverticulitis.

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Main Results:

  • CT scanning enables early diagnosis and percutaneous drainage of abscesses, enhancing antibiotic therapy effectiveness.
  • Successful drainage resolves acute episodes in 75% of patients, converting emergent surgery to elective procedures.
  • Interventional surgery is vital for perforation and obstruction, with resection and primary anastomosis being preferable to Hartmann's procedure under favorable conditions.

Conclusions:

  • Early diagnosis and CT-guided percutaneous drainage significantly improve outcomes for diverticulitis patients.
  • Resection with primary anastomosis is increasingly preferred over Hartmann's procedure for complicated diverticulitis, offering lower morbidity.
  • A single-stage resection and anastomosis is the standard elective treatment for symptomatic fistulas and strictures.