[Surgical treatment of sigmoid diverticulitis]

Diverticular disease is generally benign but may be life threatening should progressive complications occur. Under these circumstances cure may only be obtained if properly performed surgery is undertaken at the right moment. The end result of a low fibre diet, diverticular disease may affect the entire colon, but always tends to particularly affect the sigmoid region. This is the usual site of complications where the etiology is related to diverticular infection associated with fecal impaction proximal to the high pressure zone at the recto-sigmoid junction. The radical treatment of sigmoid diverticulitis is rectosigmoid resection, however, this concept may be altered according to the circumstances as follows: 1 - sigmoid diverticulitis without pericolic complications 2 - peri-sigmoid complications: peri-sigmoid abscess, intestinal and vesical fistulae. 3 - generalised peritonitis due to perforation into the peritoneal cavity. The advanced age of the patient should be stressed (mean age 65 years and 25% over 75 years) associated with a high incidence of multiple organ failure and hence the high mortality in more than 50% of cases in the event of peritonitis.