Complicated sigmoid diverticulosis

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Colorectal Surgery

Background:

• Sigmoid diverticular disease is a common condition.
• Complications of sigmoid diverticular disease can lead to significant morbidity and mortality.
• Treatment outcomes for complicated sigmoid diverticular disease require evaluation.

Purpose of the Study:

• To evaluate the treatment outcomes for patients experiencing complications of sigmoid diverticular disease.
• To assess the impact of emergency versus planned surgical intervention on patient outcomes.
• To determine the optimal management strategy for complicated sigmoid diverticular disease.

Main Methods:

• A retrospective review of 15 patients treated for sigmoid diverticular disease complications over a 6-year period.
• Patients presented with perforation, peritonitis, fistulas (colovesical, colovaginal), recurrent phlegmon, or bleeding.
• Treatment strategies included emergency surgery, planned sigmoid resection, and conservative management.

Main Results:

• One patient with colovesical fistula and hematuria died from septicemia.
• Emergency surgery for perforation and peritonitis had a high morbidity, including wound sepsis and prolonged hospitalization for some survivors.
• Planned sigmoid resection resulted in uneventful recovery for all patients, and conservative management was successful for bleeding complications.

Conclusions:

• Complicated sigmoid diverticular disease is associated with high morbidity and mortality, particularly when emergency surgery is required.
• Prompt surgical intervention in acute settings increases risks.
• Interval sigmoid resection following recovery from acute complications is recommended for improved patient outcomes.