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Published on: February 12, 2022
[Surgical treatment of diverticulitis: the current state of affairs]
Nils P van der Beeke1,2, Henderik L van Westreenen1, Willem A Bemelman3
1Isala, afd. Chirurgie, Zwolle.
Abstract:
Diverticulitis is a common benign gastrointestinal condition with a variable clinical course, ranging from mild, self-limiting episodes to severe presentations requiring surgery. This article presents two contrasting cases of diverticulitis requiring surgery: one of recurrent, uncomplicated diverticulitis, and another of acute diverticulitis with a covered perforation progressing to purulent peritonitis. These cases illustrate the broad spectrum of disease severity and the evolving, individualized approach to management. Elective sigmoid resection may improve quality of life in patients with colonic stenosis, diverticular fistula, or with recurrent and chronic symptoms, while acute complications such as perforation and peritonitis necessitate direct surgical intervention. Current evidence supports minimally invasive techniques and primary anastomosis in the majority of patients, even in emergency settings. The article underscores the importance of shared decision-making, appropriate diagnostic work-up, and patient tailored treatment strategies for optimal outcomes for patients with diverticulitis.
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