[Diverticulitis of the colon. Diagnosis and treatment illustrated by a patient material]

During the period 1985-92, 181 patients were treated at Aker Hospital for diverticulitis of the colon. 106 patients (59%) were treated conservatively, and 75 (41%) were operated on for complications. The mortality among the patients treated conservatively was 4.7%. 47 patients underwent operation in the acute stage, most often for perforation or intestinal obstruction, and the most frequent operation was the Hartmann procedure. 28 patients had an elective operation, the most common indication being a fistula from the colon. In this group the operation was usually resection with anastomosis. After acute operation, 17 patients (36%) experienced surgical complications, and the mortality was 12.8% (six patients). After elective operation the morbidity was low (2/28), and the mortality was nil. Our preferred principle for acute surgery for diverticulitis is colonic resection. This eliminates the source of contamination, and allows debridation and cleansing of the peritoneum.