Management of perforating diverticulitis of the colon

A retrospective study was carried out of all patients admitted to the hospital with either local or free perforating diverticulitis. Fifty-one patients had perforating diverticulitis of the sigmoid colon with local abscess formation, while 26 patients had free perforation with generalized peritonitis. Of the 67 patients who had a defunctioning colostomy, 18 died, while of ten patients who had either resection or exteriorization of the perforated segment, one died. Thus, exteriorization or resection as the primary surgical procedure for perforating diverticulitis is the procedure of choice, since it leads to a low operative mortality because of removal of the septic focus, preventing continuing intraperitoneal soilage.