The sigmoid diverticulitis

##plugins.themes.academic_pro.article.sidebar##

Published Mar 5, 2013
Download
pdf
Vol. 91 No. 2 (2013): Issue Feb 2013

##plugins.themes.academic_pro.article.main##

Amine Makni
Mohamed Jouini
Montassar Kacem
Zoubeir Ben Safta

Abstract

Background: The sigmoid diverticulitis is the most common complication of diverticulosis of the colon. The remaining questions concern the current risk factors for recurrence after a first acute episode, radiological asking immediately upon suspicion of diverticulitis and therapeutic management including the indications of surgical treatment, what to conduct and its principles.
Methods: Literature review
Results: Risk factors of recurrence are: persistent or recurrent diverticulitis, abscess, stenosis and / or fistula. Abdominal CT is recommended in all patients clinically suspected diverticulitis of the colon. Treatment of acute diverticulitis is medical. The emergency surgical treatment depends on the stage of Hinchey. Stage I: In case of failure of medical treatment, resection-anastomosis in an emergency time delay to be proposed. Stage II: a percutaneous drainage followed by resection-anastomosis in 1 time. Stage III: surgery in emergency sigmoid colectomy based on. Stage IV: Hartmann procedure is the procedure of citationsRaw. Prophylactic colectomy is proposed in the case of presence of risk factors of recurrence.
Conclusion: Comparison with other literature review were allowed to find that ultrasound made by an experienced radiologist could replace abdominal CT, and for stage III and IV Hinchey, laparoscopic resection can be performed with an immediate restoration of digestive continuity in well selected patients.

Keywords:

Sigmoid diverticulitis, treatment, management

##plugins.themes.academic_pro.article.details##

References

  1. Loiseau D, Borie F, Agostini H, Millat B. Diverticulite sigmoïdienne. Gastroenterol Clin Biol 2005 ;29 :809-16
  2. Ferzoco LB, Raptopoulos V, Silen W. Acute diverticulitis. N Engl J Med 1998 ;338 :1521-6
  3. Stollman N, Raskin JB. Diverticular disease of the colon. Lancet 2004;363:631-9.
  4. Cook DJ, Guyatt GH, Laupacis A, et al. Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 1992;102:305S-311S
  5. Hinchey EJ, Schaal PGH, Richards GK. Treatment of perforated diverticular disease of the colon. Adv Surg 1978;12:85-109
  6. Sackett DL, Strauss SE, Richardson WS, Rosenberg W, Haynes RB. In Evidence-Based medecine : How to practice and teach EBM. London ; Churchill Livingstone, 2000.
  7. Chautems RC, Ambrosetti P, Ludwig A, Mermillod B, Morel P, Soravia C. Long-term follow-up after first acute episode of sigmoid diverticulitis: Is surgery mandatory? A prospective study of 118 patients. Dis Colon Rectum 2002;45:962-6
  8. Parks TG. Natural history of diverticlar disease of the colon. Clin Gastroenterol 1975;4:53-69
  9. Ambrosetti P, Robert J, Witzig JA, et al. Prognostic factors from computed tomography in acute left colonic diverticulitis. Br J Surg 1992;79:117-9
  10. Ambrosetti P. Diverticulite sigmoïdienne: quand et à qui proposer une colectomie élective. Ann Chir 2002 ;127:413-5
  11. The standards Task Force, American Society of Colon and Rectal Surgeons. Practice parameters for sigmoid diverticulitis. Surg Laparosc Endosc Percutan Tech 2000;10:142-8
  12. Ambrosetti P, Becker C, Terrier F. Colonic diverticulitis: Impact of imaging on surgical management- A prospective study of 542 patients. Eur Radiol 2002;12:1145-9
  13. ChoKC, Morehouse HT, Alterman DD, Thornhill BA. Sigmoid diverticulitis: diagnostic role of CT-compression with barium enema studies. Radiology 1990;176:111-5
  14. Chautems R, Ambrosetti P, Soravia C, Morel P. Diverticulite sigmoidienne: développements récents dans la prise en charge. Méd Hyg 2002 ;60 :1222-5
  15. Pradel JA, Adell JF, Taourel P, Djafari M, Monnin-Delhom E, Bruel JM. Acute coloic diverticulitis: prospective comparative evaluation with US and CT. Radiology 1997;205:503-12
  16. Stollman NH, Raskin JB. Diagnosis and management of diverticular disease of the colon in adults. Ad Hoc Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1999;94:3110-21
  17. Rao PM, Rhea JT. Colonic diverticulitis: evaluation of the arrowhead sign and the inflamed diverticulum for CT diagnosis. Radiology 1998;209:775-9
  18. Kircher MF, Rhea JT, Kihiczak D, Novelline RA. Frequency, sensivity and specifity of individual signs of diverticulitis on thinsection helical CT with colonic contrast material: Experience with 312 cases. Am J Roentgenol 2002;178:1313-8
  19. Ambrosetti P, Grossholz M, Becker C, Terrier F, Morel P. Computed tomography in acute left colonic diverticulitis. Br J Surg 1997;84:532-4
  20. Maniatis V, Chryssikopoulos H, Roussakis A, et al. Perforation of the alimentary tract : evaluation with computed tompography. Adom Imaging 2000;25 :373-9
  21. Jang HJ, Lim HK, Lee SJ, Lee WJ, Kim EY, Kim SH. Acute diverticulitis of the cecum and ascending colon: the value of thinsection helical CT findings in excluding colonic carcinoma. AJR Am J Roentgenol 2000;174:1397-402
  22. Mizuki A, Nagata H, Tatemichi M, et al. The out-patient management of patients with acute mild-to-moderate colonic diverticulitis. Aliment Pharmacol Ther 2005;21:889-97
  23. Mueller PR, Saini S, Wittenburg J, et al. Sigmoid diverticular abscesses: percutaneous drainage as an adjunct to surgical resection in 24 cases. Radiology 1987;164:321-5
  24. Stabile BE, Puccio E, VanSonnenberg E, Neff CC. Preoperative percutaneous drainage of diverticular abscesses. Am J Surg 1990;159:99-104
  25. Thaler K, eiss EG, Nogueras JJ, Arnaud J, Wexner SD, Bergamaschi R. Recurrence rates at minimum 5-year follow-up: laparoscopic vs open sigmoid resection for uncomplicated diverticulitis. Surg Laparosc Endosc Percut Techn 2003;13:325-7
  26. Wolf BG, Ready RL, MacCarty RL, Dozois RR, Beart RW. Influence of sigmoid resection on progression of diverticular disease of the colon. Dis Colon Rectum 1984;27:645-7
  27. Chen HH, Wexner SD, Iroatulam AJN, et al. Laparoscopic colectomy compares favourably with colectomy by laparotomy for reduction of postoperative ileus. Dis Colon Rectum 2000;43:61-5
  28. Tuech JJ, Pessaux P, Regenet N, Bergamaschi R, Arnaud JP. Laparoscopic vs Open Colectomy for sigmoid diverticulitis. A prospective comparative study in the elderly. Surg Endosc 2000;14:1031-3
  29. Senagore AJ, Duepree HJ, Delancy CP, Dissanaike S, Brady K, Fazio VW. Cost structure of laparoscopic and open sigmoid colectomy for diverticular disease: Similarities and differences. Dis Colon Rectum 2002;45:485-90
  30. Kasparek MS, Muller MH, Glatzle J, et al. Prospective colonic motility in patients following laparoscopic assisted and open sigmoid colectomy. J Gastrointest Surg 2003;7:1073-81
  31. Alves A, Panis Y, Slim K, Heyd B, Kwiatkowski F, Mantion G. French multicentre prospective observational study of laparoscopic versus open colectomy for sigmoid diverticular disease. Br J Surg 2005;92:1520-5
  32. Stevenson ARL, Stitz RW, Lumley JW, Fielding GA. Laparoscopically assisted anterior resection for diverticular disease: follow-up of 100 consecutive patients. Ann Surg 1998;227:335-42
  33. Vargas HD, Ramirez RT, Hoffman CC, et al. Defining the role of laparoscopic-assisted sigmoid colectomy for diverticulitis. Dis Colon Rectum 2000;43:1726-31
  34. Schwandner O, Farke S, Bruch HP. Laparoscopic colectomy for diverticulitis is not associated with increased morbidity when compared with non-diverticular disease. Int J Colorectal Dis 2005;20:165-72
  35. Tocchi A, Mazzoni G, Fornassi V, Miccini M, Daddi G, Tagliacozzo S. Preservation of the inferior mesenteric artery in colorectal resection for complicated diverticular disease. Am J Surg 2001;182:162-7
  36. Benn PL, Wolff BG, Ilstrup DM. Level of anastomosis and recurrent colonic diverticulitis. Am J Surg 1986;151:269-71
  37. Thaler K, Baig MK, Berho M, et al. Determinants of recurrence after sigmoid resection for uncomplicated diverticulitis. Dis Colon Rectum 2003;46:385-8
  38. Bergamaschi R, Tuech JJ, Cervi C, Arnaud JP. Re-establish pneumoperitoneum in laparoscopic-assisted sigmoid resection? Randomized trial. Dis Colon Rectum 2000;43:771-4
  39. Fingerhut A, Hay JM, Elhadad A, Lacaine F, Flamant Y. Supraperitoneal colorectal anastomosis: hand-sewn versus circular staples: a controlled clinical trial. Surgery 1995;118:479-85
  40. Rose J, Schneider C, Yildirim C, Geers P, Scheibach H, Köckerling F. Complications in laparoscopic colorectal surgery: results of a multicentre trial. Tech Coloproctol 2004;8:s25-8
  41. Kronborg O. Treatment of perforated sigmoid diverticulitis: a prospective randomized trial. Br J Surg 1993;80:505-7
  42. Zeitoun G, Laurent A, Rouffet F, et al. Multicentre randomized clinical trial of primary versus secondary sigmoid resection in generalized peritonitis complicating sigmoid diverticulitis. Br J Surg 2000;87:1366-74
  43. Nagorney DM, Adson MA, Pemberton JH. Sigmoid diverticulitis with perforation and generalized peritonitis. Dis Colon Rectum 1985;28:71-5
  44. Belding HH. Acute perforated diverticulitis of the sigmoid colon with generalized peritonitis. AMA Arch Surg 1957;74:511-5
  45. Dudley HAF, Radcliffe AG, McGeehan D. Intra operative irrigation of the colon to permit primary anastomosis. Br J Surg 1980;67:80-1
  46. Koruth NM, Krokowski ZH, Youngson GG, et al. Intraoperative colonic irrigation in the management of left-sided large bowel emergencies. Br J Surg 1985;72:708-11
  47. Salem L, Flum DR. Primary anastomosis or Hartmann's procedure for patients with diverticular peritonitis? A systematic review. Dis Colon Rectum 2004;47:1953-64
  48. Biondo S, Jaurricta E, Marti Rague J, et al. Role of resection and primary anastomosis of the left colon in the presence of peritonitis. Br J Surg 2000;87:1580-4
  49. Regenet N, Pessaux P, Hennekinne S, et al. Primary anastomosis after intraoperative colonic lavage vs Hartmann's procedure in generalized peritonitis complicating diverticular disease of the colon. Int J Colorect Dis 2003;18:503-7
  50. Schilling MK, Maurer CA, Kollmar O, Büchler MW. Primary vs secondary anastomosis after sigmoid colon resection for perforated diverticulitis (Hinchey Stage III and IV). A prospective outcome and cost analysis. Dis Colon Rectum 2001;44:699-703
  51. Gooszen AW, Gooszen HG, Veerman W, et al. Operative treatment of acute complications of diverticular disease: Primary or secondary anastomosis after sigmoid resection. Eur J Surg 2001;167:35-9
  52. Maggard MA, Chandler CF, Schmit PJ, Bennion RS, Hines OJ, Thompson JE. Surgical diverticulitis: treatment options. Am Surg 2001;67:1185-9
  53. Alanis A, Papanicolaou GK, Tadros RR, Fielding LP. Primary resection and anastomosis for treatment of acute diverticulitis. Dis Colon Rectum 1989;32:933-9
  54. Wedell J, Banzhaf G, Chaoui R, Fisher R, Reichmann J. Surgical management of complicated colonic diverticulitis. Br J Surg 1997;84:380-3
  55. Ambrosetti P, Michel JM, Megevand JM, Morel P. La colectomie gauche avec anastomose immediate dans la chirurgie d'urgence. Ann Chir 1999;53:1023-8
  56. Lee EC, Murray JJ, Coller JA, Roberts PL, Schoetz DJ. Intraoperative colonic lavage in nonelective surgery for diverticular disease. Dis Colon Rectum 1997;40:669-74
  57. Cady J, Godfroy J, Sibaud O. La resection -anastomose d'emblée dans les sigmoidites diverticulaires perforées. A propos de cinquante-huit péritonites dont trente et une généralisée. Ann Chir 1991; 45 :896-900
  58. Woods RJ, Lavey IC, Fazio VW, Jagelman DG, Weakley FL. Internal fistulas in diverticular disease. Dis Colon Rectum 1988;31:591-6
  59. Joo JS, Agachan F, Wexner SD. Laparoscopic surgery for lower gastrointestinal fistulas. Surg Endosc 1997;11:116-8
  60. Poulin EC, Schlachta CM, Mamazza J, Seshadri PA. Should enteric fistulas from Crohn's disease or diverticulitis be treated laparoscopically or by open surgery? A matched cohort study. Dis Colon Rectum 2000;43:621-6
  61. Menenakos E, Hahnloser D, Nassiopoulos K, Chanson C, Sinclair V, Petropoulos P. Laparoscopic surgery for fistulas that complicate diverticular disease. Langenbeck's Arch Surg 2003;388:189-93
  62. Köckerling F, Schneider C, Reymond MA, et al. Laparoscopic resection of sigmoid diverticulitis. Results of a multicenter study. Laparoscopic Colorectal Study Group. Surg Endosc 1999;13:567- 71.
  63. European Association for Endoscopic Surgery, Köhler L, Sauerland S, Neugebauer E. Diagnosis and treatment of diverticular disease. EAES consensus statement. Surg Endosc 1999;13:430-6