Abstract
In a prospective evaluation of 140 consecutive patients with acute left-sided colonic diverticulitis demonstrated by computerized tomography (CT) in all cases, 22 (16 percent) were found to have an associated abscess without peritonitis. Thirteen of these 22 required surgery (seven during the first stay and six from 2 to 11 months after the acute episode; median, three months). Nine patients were treated conservatively, eight of whom are now totally asymptomatic 24 months after the initial attack (range, 10–47 months). There were 10 mesocolic abscesses (seven treated with antibiotics alone), nine pelvic abscesses (seven requiring surgery), and three intra-abdominal abscesses, all operated upon. These results suggest that mesocolic abscesses can usually be managed conservatively without drainage; should surgery be necessary,en bloc resection with immediate anastomosis can usually be safely performed. Pelvic and intra-abdominal abscesses behave more aggressively and usually require a two-stage surgical procedure when initial percutaneous drainage cannot be performed or is felt to be hazardous.
Article PDF
Similar content being viewed by others
Explore related subjects
Discover the latest articles, news and stories from top researchers in related subjects.Avoid common mistakes on your manuscript.
References
Killingback M. Management of perforative diverticulitis. Surg Clin North Am 1983;63:97–115.
Alexander J, Karl RC, Skinner DB. Results of changing trends in the surgical management of complications of diverticular disease. Surgery 1983;94:683–90.
Rodkey GV, Welch CE. Changing patterns in the surgical treatment of diverticular disease. Ann Surg 1984;200:466–78.
Saini S, Mueller PR, Wittenberg J, Butch RJ, Rodkey GV, Welch CE. Percutaneous drainage of diverticular abscess. An adjunct to surgical therapy. Arch Surg 1986;121:475–8.
Mueller PR, Saini S, Wittenberg J,et al. Sigmoid diverticular abscess; percutaneous drainage as an adjunct to surgical resection in 24 cases. Radiology 1987;164:321–5.
Greco RS, Kamath C, Nosher JL. Percutaneous drainage of peridiverticular abscess followed by primary sigmoidectomy. Dis Colon Rectum 1982;25:53–5.
Dixon WJ. Statistical software. Berkeley: University of California Press, 1988.
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.
Hulnick DH, Megibow AG, Balthazar EJ, Nadich DP, Bosniak MA. Computed tomography in the evaluation of diverticulitis. Radiology 1984;152:491–5.
Teitelbaum GP. Technical note: use of a double-needle technique for safer entry into an abdominal abscess. Cardiovasc Intervent Radiol 1988;11:354–6.
Author information
Authors and Affiliations
About this article
Cite this article
Ambrosetti, P., Robert, J., Witzig, J.A. et al. Incidence, outcome, and proposed management of isolated abscesses complicating acute left-sided colonic diverticulitis. Dis Colon Rectum 35, 1072–1076 (1992). https://doi.org/10.1007/BF02252998
Issue Date:
DOI: https://doi.org/10.1007/BF02252998