Peritonitis due to complications of colonic diverticular disease: Operative tactic and results

Peritonitis por complicación de la enfermedad diverticular colónica: Táctica operatoria y resultados

Asiner, Boris

Resumen:

The author's personal experience and results in peritóneal complications of the cliverticular colonic disease ( D.C.D.) are presented. A review is made of 30 cases selected · of a series of 230 patients presenting D.C.D.Preoperative diagnosis was correct in only 34 % of the cases. In 66 % other diagnosis were considered ( apendicitis, perforating ulcer, etc.). In all cases, however, operative diagnosis was established. The clasic perforative sindrome was absent in the majority of the cases, in which the symptomatology was progressive .Plain X Ray study is considered of main importance. The most frequently founded lesion was sigmoiditis with peritoneal extension. In oniy 3 % of cases perforation of one diverticul rended evident was present. Total mortality was 30 % . Various surgical procedures were utilized: primary resection in 6 cases with anastomosis in 2 of them, with good results. If the patient's conditions and with qualified surgeon and anaesthetict, primary resection is advisable. In other circunstances, differente kinds of colostomy and drainage should be used.


El autor presenta su experiencia y resultados en el tratamiento de las complicaciones peritoneales de la E.D.C. Analiza 30 casos de una serie de 230 pacientes con E. D. C. El diagnóstico preoperatorio fue correcto sólo en 34 % de los casos. Enel restante 66 % otros diagnósticos fueron  planteados ( apendicitis, úlcera perforada,etc.). En todos los casos, sin embargo, se hizo el diagnóstico operatorio. El síndrome, clínico perforativo clásicono estuvo presente en la mayoría de los casos, habiéndose presentado sintomatología progresiva en muchos. El examen radiológico simple de abdomen se considera fundamental. La lesión más frecuentemente hallada fue la sigmoiditis con participación peritoneal. En sólo 3 casos se encontró perforación evidente. La mortalidad global fue del 30 % . Los procedimientos operatorios utilizados fueron diversos;se hizo resección primaria en 6 casos, habiéndose restablecido la continuidad colónica en 2 de ellos, teniendo evolución favorable. Si las condiciones ambientales (cirujano, anestesista, etc.) y del paciente, son favorables, es aconsejablela exéresis en agudo del sector sigmoideo afectado. En otras situaciones seoptará por los diversos procedimientos dedrenaje y derivación fecal externa.


Detalles Bibliográficos
1971
perforación del colon
divertículo
peritoneo
colon perforation
diverticulum
peritoneum
Español
Sociedad de Cirugía del Uruguay
Revista Cirugía del Uruguay
https://revista.scu.org.uy/index.php/cir_urug/article/view/2163
Acceso abierto
Resumen:
Sumario:The author's personal experience and results in peritóneal complications of the cliverticular colonic disease ( D.C.D.) are presented. A review is made of 30 cases selected · of a series of 230 patients presenting D.C.D.Preoperative diagnosis was correct in only 34 % of the cases. In 66 % other diagnosis were considered ( apendicitis, perforating ulcer, etc.). In all cases, however, operative diagnosis was established. The clasic perforative sindrome was absent in the majority of the cases, in which the symptomatology was progressive .Plain X Ray study is considered of main importance. The most frequently founded lesion was sigmoiditis with peritoneal extension. In oniy 3 % of cases perforation of one diverticul rended evident was present. Total mortality was 30 % . Various surgical procedures were utilized: primary resection in 6 cases with anastomosis in 2 of them, with good results. If the patient's conditions and with qualified surgeon and anaesthetict, primary resection is advisable. In other circunstances, differente kinds of colostomy and drainage should be used.