Diverticular disease

The diverticulitis consists of inflammation of different intensity of one or more diverticulas, from simple flogosi to fulminant form with free perforation and diffused peritonitis. Perforation of the diverticulus generally causes the diverticulitis attack. Often the diverticular attack is confused with painful spasms of the irritable colon. The episode of diverticolitis can be simple, and in that case it is solved by medical therapy, or complicated by abscess, perforation, obstruction, fistula (colon, colouterine, etc.), requiring surgery. The symptoms accused during a diverticulitis attack are: abdominal pain, fever, anorexia, sometimes dysuria and urinary urgency. Leukocytosis is always present, whereas in only 20% of cases abdominal mass can be palpable. Patients with severe acute diverticulitis should be hospitalized. If after the first 24 to 48 hours the clinical picture does not improve with medical treatment and complications have occurred, the patient should be undergoing surgery. Absolute indications are massive haemorrhage, abscesses and peritonitis, fistulae, obstructions, recurrent inflammatory episodes, etc. The intervention can be performed with a single approach: colon resection and primary anastomosis with or without colostomy protection. Or resection of the colon, suture of the rectum, colostomy followed by a few months from colorectal anastomosis.

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