Abstract
We observed five cases of unusual extraperitoneal presentation of diverticulitis during an 11 year period. During that time, a total of 263 patients were operated for diverticulitis. Patients 1–4 presented with an inflammatory spread of diverticulitis through the abdominal wall; in patient 5 multiple abscesses were present in the left thigh. Inadequate resection and previous radiotherapy in patient 4 might have contributed to the complicated course. In patient 5, poor condition initially allowed only local drainage of the thigh abscesses. Despite laparotomy and sigmoid resection a few days after drainage, the fatal outcome could not be prevented. A more extensive resection and a protecting colostomy might have prevented the fistulous complication in patient 4. A primary resection and abscess drainage might have averted the fatal outcome in patient 5.
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Rotstein OD, Pruett TL, Simmons RL: Thigh abscess, an uncommon presentation of intraabdominal sepsis. Am J Surg 151:414–418, 1986
Ravo B, Khan SA, Ger R, Mishrick A, Soroff HS: Unusual extraperitoneal presentations of diverticulitis. Am J Gastroenterol 80(5):346–351, 1985
Rodkey GV, Welch CE: Colonic diverticular disease with surgical treatment. Surg Clin North Am 54:655–665, 1974
Woods RJ, Lavery IC, Fazio VW, Jagelman DG, Weakley FL: Internal fistulas in diverticular disease. Dis Colon Rectum 31:591–596, 1988
Stahlgren LH, Thabit G: Subcutaneous emphysema: Important sign of intra-abdominal abscess. Ann Surg 153:126–133, 1961
Krukowski ZH, Matheson NA: Emergency surgery for diverticular disease complicated by generalized and faecal peritonitis: a review. Br J Surg 71:921–927, 1984
Ravo B, Misirick A, Addei K, Castrini G, Pappalardo G, Gross E, Sackier JM, Wood CB, Ger R: The treatment of perforated diverticulitis by one-stage intracolonic bypass procedure. Surgery 102:771–776, 1987
Ravo B, Metwell N, Yeh J, Polansy P, Frattaroli FM: Effect of fecal loading with/without peritonitis on the healing of a colonic anastomosis. An experimental study. Eur Surg Res 23:100–107, 1991
Bell GA, Panton ONM: Hartmann resection for perforated sigmoid diverticulitis. A retrospective study of the Vancouver General Hospital experience. Dis Colon Rectum 27:253–256, 1984
Kjaergaard J, Fischer AB, Baden H: Hartmann's operation as an emergency procedure for perforation of the sigmoid colon. Acta Chir Scand 150:255–257, 1984
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Rothenbuehler, J.M., Oertli, D. & Harder, F. Extraperitoneal manifestation of perforated diverticulitis. Digest Dis Sci 38, 1985–1988 (1993). https://doi.org/10.1007/BF01297073
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DOI: https://doi.org/10.1007/BF01297073