Damage control surgery for perforated diverticulitis with diffuse peritonitis: saves lives and reduces ostomy
Over the last decade, damage control surgery (DCS) has been emerging as a feasible alternative for the management of patients with abdominal infection and sepsis. So far, there is no consensus about the role o...
ConclusionLPL is related to a higher reoperation rate, more frequent postoperative ongoing sepsis, and higher recurrence rates. Therefore, laparoscopic lavage for perforated diverticulitis carries a high risk of failure in daily practice.
CONCLUSIONAlthough Meckel's diverticulitis is a rare entity, it can appear as an acute abdomen. An early diagnosis and treatment to prevent subsequent complications is essential to ensure an optimal recovery.
This study aimed to investigate the factors affecting the postoperative mortality rate in patients undergoing surgery for perforated diverticulitis. Further, we compared the recovery courses of patients between open and laparoscopic surgeries. Methods: We analyzed the medical records of adult patients with peritonitis caused by perforated diverticulitis from six hospitals of Hallym University Medical Center from January 2006 to December 2016. Results: A total of 166 patients were identified. In the univariate analysis, the statistically significant factors associated with postoperative mortality were age ≥ 60 ye...
CONCLUSIONS: LALA, as a bridge treatment, before EE and resection, in patients presenting a perforated diverticulitis with purulent peritonitis, associated with an uncomplicated AAA, may be an effective treatment option. KEY WORDS: Perforated diverticulitis, Purulent peritonitis, Abdominal aortic aneurysm. PMID: 31354156 [PubMed - in process]
Authors: You H, Sweeny A, Cooper ML, Von Papen M, Innes J Abstract Radiological evidence of inflammation, using computed tomography (CT), is needed to diagnose the first occurrence of diverticulitis. CT is also warranted when the severity of symptoms suggests that perforation or abscesses have occurred. Diverticulitis is classified as complicated or uncomplicated based on CT scan, severity of symptoms and patient history; this classification is used to direct management. Outpatient treatment is recommended in afebrile, clinically stable patients with uncomplicated diverticulitis. For patients with uncomplicated div...
Condition: Damage Control for Perforated Diverticulitis Intervention: Procedure: Damage control surgery Sponsor: Medical University Innsbruck Completed
ConclusionThe diagnosis of severe acute UC in elderly patients with acute abdomen had been complicated by the distinctive physiology of this aged group with atypical presentation and markedly unreliable physical examination. Eventually, severe UC should always be kept in mind with a circumstance of abdominal pain in geriatric population.
For stable patients with perforated diverticulitis and peritonitis, sigmoidectomy with primary anastomosis provides better outcomes than does Hartmann's procedure, according to results from the LADIES trial.Reuters Health Information
Conclusions. DCS with temporary abdominal closure by negative pressure wound therapy combined with instillation in patients with diffuse peritonitis from complicated diverticulitis could represent a feasible surgical option both in hemodynamically stable and no stable patients, showing encouraging results including a low stoma rate and an acceptable morbidity rate. PMID: 31221028 [PubMed - as supplied by publisher]
Authors: Gachabayov M, Oberkofler CE, Binda GA, Regimbeau JM, Hahnloser D, Tuech JJ, Bergamaschi R Abstract BACKGROUND: The impact of specific interventions at resection with primary anastomosis (PRA) for perforated diverticulitis with peritonitis is controversial. The aim of this pooled analysis was to determine whether any specific interventions performed at resection with primary anastomosis in patients with perforated diverticulitis with peritonitis influenced the outcomes. PMID: 31037716 [PubMed - as supplied by publisher]