Iriñiz AM, Urbina E, Montiel M, Soledad DM

Language: Spanish
References: 16
Page: 4-8
PDF size: 38.96 Kb.

ABSTRACT

The treatment of complications of the colon diverticular disease, was diverse in a long of the years with the incorporation of diagnostic’s methods and the new therapeutic advances. Objective: Treatment revision of these complications in the general surgery service. Methods: Retrospective observational study in 55 patients in the hospital from January of 2002 to September 2007. The study was divided in 4 groups in agreement of they complications: Inflammatory, hemorrhagic, occlusive and fistulas. Results: The 58% presented inflammatory complication (stage 1 of Hinchey), 27% presented hemorrhagic complication, 11% occlusive and 4% fistulas. The 62% with inflammatory complication received medical treatment. With 80% of success. The 37.5% needed percutaneous drainage and surgery with a morbidity and resolution of 56%. The 19% from hemorrhagic and occlusive required surgery. Conclusions: The most frequent complication of the diverticular disease was the inflammatory. The incorporation of the TAC and endoscopic methods as well the new therapeutic permit to offer the alternative of the treatment, were the surgery still continue the most important of the option.

REFERENCES

1. H. Nail Aydin. Evaluation of the risk of a nonrestorative resection for the treatment of diverticular disease: The Cleveland Clinic Diverticular Disease Propensity Score. Dis Colon Rectum 2006; 49: 629-639.

2. Mc Conell EJ. Population-based incidence of complicated diverticular disease of the sigmoid colon based on gender and age. Dis Colon Rectum 2003; 46: 1110-1114.

3. Ambrosetti P. Long-term outcome of mesocolic and pelvis diverticular abscesses of the left colon: A prospective study of 73 cases. Dis Colon Rectum 2005; 48: 787-791.

4. Viscido G. ¿Es la diverticulitis de colon sigmoides una enfermedad más agresiva en pacientes menores de 50 años? Rev Argent Coloproct 2007; 18: 376-381.

5. Rivas DB. Resección con anastomosis primaria en la colopatía diverticular inflamatoria aguda. Rev Argent Coloproct 2007; 18: 349-353.

6. Constantinides VA. Primary resection with anastomosis vs. Hartmann’s procedure in monoelective surgery for acute colonic diverticulitis: A systematic review. Dis Colon Rectum 2006; 49: 966-80.

7. Bonadeo LFA. Nuevas estrategias en la enfermedad diverticular del colon. Relato Oficial del 30° Congreso Argentino de Coloproctología. Buenos Aires, Argentina. Rev Arg Coloproct 2005.

8. Schoetz DJ. Diverticular disease of the colon: a Century old problem. Dis Colon Rectum 1999; 42: 703-9.

9. Stollman NH. Diagnosis and management of diverticular disease of the colon in adults. Am J Gastroenterol 1999; 94: 3110-21.

10. Amarillo H. Patología diverticular. Programa de Actualización Continua en Cirugía (PROACI); Ciclo 2, Fascículo 3, Unidad 10. p. 229-46.

11. Lambert ME. Management of the septic complications of diverticular disease. Br J Surg 1986; 73: 576-9.

12. Wedell J. Surgical management of complicated colonic diverticulitis. Br J Surg 1997; 84: 664-7.

13. Peoples JB. Reassessment of primary resection of the perforated segment for severe colonic diverticulitis. Am J Surg 1990; 159: 291-4.

14. Schein M. The Hartmann procedure. Extended indications in severe intra-abdominal infection. Dis Colon Rectum 1988; 31: 126-9.

15. Billing A. Prediction of outcome using the Mannheim peritonitis index in 2,003 patients. Peritonitis Study Group. Br J Surg 1994; 81: 209-13.

16. Hinchey EJ. Treatment of perforated diverticular disease of the colon. Adv Surg 1978; 12: 85-109.