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Perforated diverticulitis: a surgical dilemma.
Int Surg. 1992 Jan-Mar; 77(1):44-7.IS

Abstract

Thirty-eight patients, 18 males and 20 females (mean age 61 years) have been operated on for perforated diverticulitis, over the past 14 years. We assigned the patients into stage A (n = 12) when the inflammation was confined to the mesosigmoid folds, stage B (n = 16) when an intraabdominal abscess was walled off and stage C (n = 10) when a generalized peritonitis had developed. Resection of the perforated sigmoid was carried out in 24 patients either as Hartmann's procedure (n = 18) or with primary anastomosis (n = 6). The mortality rate in this setting was 0.0% and 16.6% respectively. In 14 patients, no resection was carried out in 24 patients either drainage and colostomy (n = 10) or only drainage (n = 4) with corresponding mortality rate 30% and 25%. Mortality rate in relation to the stage was: Stage A 16.16%, Stage B 12.5% and Stage C 10%. The higher mortality rate in stage A and B was due to the fact that less radical operations were carried out. Four of our five deaths in all stages occurred in patients in whom the perforated sigmoid was not resected. In conclusion resection of the perforated sigmoid with or without primary anastomosis regardless of the stage of the disease is recommended.

Authors+Show Affiliations

2nd Surgical Clinic, Medical School, University of Athens, "Areteion" Hospital, Greece.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1577579

Citation

Smirniotis, V, et al. "Perforated Diverticulitis: a Surgical Dilemma." International Surgery, vol. 77, no. 1, 1992, pp. 44-7.
Smirniotis V, Tsoutsos D, Fotopoulos A, et al. Perforated diverticulitis: a surgical dilemma. Int Surg. 1992;77(1):44-7.
Smirniotis, V., Tsoutsos, D., Fotopoulos, A., & Pissiotis, A. C. (1992). Perforated diverticulitis: a surgical dilemma. International Surgery, 77(1), 44-7.
Smirniotis V, et al. Perforated Diverticulitis: a Surgical Dilemma. Int Surg. 1992 Jan-Mar;77(1):44-7. PubMed PMID: 1577579.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perforated diverticulitis: a surgical dilemma. AU - Smirniotis,V, AU - Tsoutsos,D, AU - Fotopoulos,A, AU - Pissiotis,A C, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez SP - 44 EP - 7 JF - International surgery JO - Int Surg VL - 77 IS - 1 N2 - Thirty-eight patients, 18 males and 20 females (mean age 61 years) have been operated on for perforated diverticulitis, over the past 14 years. We assigned the patients into stage A (n = 12) when the inflammation was confined to the mesosigmoid folds, stage B (n = 16) when an intraabdominal abscess was walled off and stage C (n = 10) when a generalized peritonitis had developed. Resection of the perforated sigmoid was carried out in 24 patients either as Hartmann's procedure (n = 18) or with primary anastomosis (n = 6). The mortality rate in this setting was 0.0% and 16.6% respectively. In 14 patients, no resection was carried out in 24 patients either drainage and colostomy (n = 10) or only drainage (n = 4) with corresponding mortality rate 30% and 25%. Mortality rate in relation to the stage was: Stage A 16.16%, Stage B 12.5% and Stage C 10%. The higher mortality rate in stage A and B was due to the fact that less radical operations were carried out. Four of our five deaths in all stages occurred in patients in whom the perforated sigmoid was not resected. In conclusion resection of the perforated sigmoid with or without primary anastomosis regardless of the stage of the disease is recommended. SN - 0020-8868 UR - https://www.unboundmedicine.com/medline/citation/1577579/Perforated_diverticulitis:_a_surgical_dilemma_ L2 - https://www.diseaseinfosearch.org/result/9681 DB - PRIME DP - Unbound Medicine ER -