Treatment analysis of complicated diverticula of the distal parts Of the gastrointestinal tract

Authors

  • V. O. Shaprynskyi National Pirogov Memorial Medical University, Vinnytsia
  • Y. V. Shaprynskyi National Pirogov Memorial Medical University, Vinnytsia
  • A. V. Verba National Pirogov Memorial Medical University, Vinnytsia
  • V. A. Korobko National Pirogov Memorial Medical University, Vinnytsia
  • V. F. Biloshchytskyi National Pirogov Memorial Medical University, Vinnytsia
  • S. S. Stukan National Pirogov Memorial Medical University, Vinnytsia
  • D. V. Mikhurinskyi National Pirogov Memorial Medical University, Vinnytsia

DOI:

https://doi.org/10.11603/2414-4533.2021.4.12716

Keywords:

diverticula of the colon, diagnostic and treatment tactics

Abstract

The aim of the work: to analyze the experience of treatment of patients with complicated diverticula of the colon, including laparoscopy and endoscopic techniques to improve and select appropriate diagnostic and treatment tactics for this pathology.

Materials and Methods. Analysis of treatment results of 121 patients who had been hospitalized in urgently way in the period from 2008 to 2021 with complications of diverticular disease was performed. There were: colon bleeding – in 60 patients, diverticulitis – in 9, perforation of the diverticulum – in 19, diverticular infiltrate – in 18. 15 patients had combination: diverticulitis and diverticular abscess – in 6, diverticulitis and peritonitis – in 4, diverticulitis with dynamic intestinal obstruction – in 5. Standard diagnostic and treatment algorithm were used.

Results and Discussion. In the group of patients with the clinical picture of colon bleeding (60) with ineffective hemostatic therapy in 7 patients we urgently performed resection of the affected segment of the colon with bleeding diverticula (left hemicolectomy (6)) and resection of the sigmoid colon (1) with end to end anastomosis. In the group of patients with inflammatory complications of diverticular disease without perforating (42) conservative general and local treatment was started. 6 patients with complication such as abscess underwent surgery. We perfomed resection of the segment of the colon with diverticular abscess and we formed terminal stoma. In the group with perforated diverticulitis (19) all patients were urgently operated. Postoperative mortality was not observed. It was not any postoperative complications from the postoperative wound in patients who underwent laparoscopic methods of diagnosis and treatment.

Consequently, the most common complications of diverticular disease are inflammatory complications and bleeding, the treatment of which is mostly conservative. Treatment tactics for inflammatory complications of diverticula is different: initially conservative with local antiinflammatory therapy, and for complications with perforation – surgical with the possible minimally invasive laparoscopic method.

References

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Published

2022-02-18

How to Cite

Shaprynskyi, V. O., Shaprynskyi, Y. V., Verba, A. V., Korobko, V. A., Biloshchytskyi, V. F., Stukan, S. S., & Mikhurinskyi, D. V. (2022). Treatment analysis of complicated diverticula of the distal parts Of the gastrointestinal tract. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (4), 49–53. https://doi.org/10.11603/2414-4533.2021.4.12716

Issue

No. 4 (2021)

Section

EXPERIENCE OF WORK

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