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[Diverticular disease: complications and treatment]
Antonio Cavallaro1, Vincenzo Loschiavo, Angelo Eugenio Potenza
1Istituto di Semeiotica Chirurgica, Università Cattolica del Sacro Cuore, Roma.
Chirurgia Italiana
|December 10, 2002
Summary
Diverticular disease management primarily involves antibiotic therapy, with surgery reserved for complex cases. This 10-year study found no mortality, highlighting effective treatment strategies for this common condition.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Clinical Medicine
Background:
- Diverticular disease affects a significant patient population, often requiring medical or surgical intervention.
- Understanding long-term outcomes and treatment efficacy is crucial for clinical practice.
Purpose of the Study:
- To analyze a decade of clinical experience with diverticular disease management.
- To evaluate the outcomes of antibiotic therapy versus surgical intervention.
- To assess morbidity and mortality rates associated with different treatment approaches.
Main Methods:
- Retrospective analysis of 77 patients (41 male, 36 female) aged 50-88 years over a 10-year period (1991-2001).
- Categorization of patients into emergency admissions (62) and elective cases (15).
- Comparison of outcomes between patients treated with antibiotics alone (72) and those undergoing emergency surgery (5).
Main Results:
- Overall mortality rate was 0%.
- Morbidity rate was 22% in patients undergoing emergency surgery.
- Wound suppuration occurred in only one elective patient.
- Antibiotic therapy alone was sufficient for most cases, but 30% required surgery.
Conclusions:
- Diverticular disease management is often successful with antibiotic therapy alone.
- Emergency surgery is necessary in a subset of patients, with colon resection and immediate anastomosis being a preferred option when safe.
- Hartman's operation is recommended for cases with severe peritoneal contamination, followed by recanalization.