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Surgical Indication on Diverticular Disease of the Colon T. Ikenaga 1 1Department of Surgery, Toranomon Hospital pp.825-832
Published Date 1980/8/25
DOI https://doi.org/10.11477/mf.1403112721
  • Abstract
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 There is no surgical indication on asymptomatic diverticular disease of the colon. However, if the patient has severe symptoms even though inflammatory findings are un-clear, operation of the right sided diverticular disease of the colon should be determined cautiously, and left sided one should be operated on positively.

 Emergency operation should be carried out for free-intraabdominal perforation of the diverticular disease of the colon. Either on the right side or left side of the colon, if a diagnosis of diverticulitis is made, a conservative treatment should be performed initially for 2~3 days and if inflammation persists, laparotomy should be done without delay. On the other hand, if flare-up of diverticulitis occurs or it complicated with fistula formation between skin or other organs, elective surgery should be performed. If laparotomy is performed with a diagnosis of appendicitis and it discose acute diverticulitis of the right side of the colon, resection of the inflammed region should be done if it is not difficult. And if it is difficult to remove the inflammed diverticulae, only appendectomy should be performed and the patient should be followed up carefully with antibiotics.

 For massive bleeding from the diverticular disease of the colon, the patient should be admitted and placed on bedrest, NPO, I. V. fluid or blood transfusion. If the above treatment are performed, hemorrhage will stop spontaneously in the majority of the cases. If hemorrhage persists and requires more than 2,000 ml of blood transfusion for the first day and more than 1,000 ml for the second day, laparotomy should be considered. In that case, it is important to perform barium enema prior to the operation to know the location of the diverticular disease.


Copyright © 1980, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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