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Fistulas complicating diverticulitis

C A Vasilevsky1, P Belliveau, J L Trudel

  • 1Department of Surgery, McGill University, Montreal, Canada.

International Journal of Colorectal Disease
|June 25, 1998
PubMed
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Surgical management of diverticulitis with fistula formation, primarily resection and anastomosis, is safe and effective. Nonoperative treatment is an option for high-risk patients, avoiding mortality and acceptable morbidity.

Area of Science:

  • Gastroenterology
  • Surgical Management
  • Diverticular Disease

Background:

  • Diverticulitis is a common condition that can lead to complications such as fistula formation.
  • Fistulas resulting from diverticulitis require appropriate management strategies.

Purpose of the Study:

  • To evaluate the effectiveness and safety of surgical and nonoperative management for patients with diverticulitis complicated by fistula formation.
  • To analyze outcomes, including morbidity and mortality, associated with different treatment approaches.

Main Methods:

  • Retrospective chart review of 42 patients with diverticulitis-related fistulas between 1975 and 1995.
  • Analysis of patient demographics, fistula types, surgical procedures (resection and anastomosis, Hartmann's operation), and nonoperative management.

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  • Assessment of postoperative complications, hospital stay, and long-term outcomes.

    • Main Results:

    • Colovesical (48%) and colovaginal (44%) fistulas were most common.
    • Resection and primary anastomosis were performed in 38 patients with no operative deaths.
    • Overall morbidity was acceptable, with common complications including urinary tract infections and atelectasis; no anastomotic leaks occurred.

    Conclusions:

    • Resection and primary anastomosis represent a safe and effective treatment for diverticulitis-induced fistulas, with low mortality and manageable morbidity.
    • Nonoperative management with antibiotics is a viable option for patients with poor performance status.
    • Surgical intervention for diverticulitis fistulas yields favorable outcomes.