CURRENT MODE OF TREATMENT IN ACUTE DIVERTICULITIS

Abstract

Purpose: The purpose of our study is to determine whether patients with acute uncomplicated diverticulitis with micro-perforation should really be treated as patients without perforation and to identify differences in recurrence rates, complications and mode of treatment Material and Methods: A total of 47 patients with a diagnosis of acute diverticulitis were admitted to the hospital for a three-year period from 01.01.2018 to 01.01.2020 in the Department of General, Visceral and Emergency Surgery at UMHATEM "Pirogov". Of those hospitalized, women were 21 (44.68%), men 26 (55.32%). The age in this retrospective analysis varied from 27 to 81 years (average 51.3 years). Results: All patients had leukocytosis, abdominal pain, and tenderness. From the group of 47 patients hospitalized with acute diverticulitis, twenty-five (53.19%) were diagnosed with micro-perforation by pneumoperitoneum data from X-ray and CT or free intraperitoneal fluid from ultrasound. The other three (6.38%) were identified intraoperatively (by laparoscopy or laparotomy) based on an indication of peritoneal irritation. The remaining 19 (40.43%) with mild symptoms for conservative management (38.89%) - through physical examination, laboratory data and imaging diagnostic methods (X-ray, ultrasound and CT). Of the 28 operated, 13 patients had laparoscopy performed lavage and drainage, with the remaining 15 (with laparotomy) - had Hartmann's procedure. Conclusion: Acute diverticulitis with micro-perforation showed no significant differences in the complications and course of antibiotic therapy compared to the group of acute diverticulitis without micro-perforation. Neither group required surgery after one-month discharge. Accordingly, to these outcomes, the mode of treatment should be identical.

Keywords

• acute diverticulitis
• approach
• micro-perforation
• conventional surgery
• laparoscopy