Abstract

APOLINAR, Andrés F.; AREVALO, Cáterin; GOMEZ, Daniel F.  and  BORRAEZ, Bernardo A.. Diverticulitis and pneumoperitoneum: A condition that not always is surgical. rev. colomb. cir. [online]. 2016, vol.31, n.3, pp.165-169. ISSN 2011-7582.

Introduction: Diverticular disease is an usual degenerative condition of the colon and frequent cause of consultation in the emergency departments because of abdominal pain. Perforation is a common complication and may result in pneumoperitoneum, an abdominal collection or peritonitis requiring drainage or surgical management. We report three patients with diverticulitis and pneumoperitoneum who received conservative treatment with adequate evolution. Objective: The aims of this study were to determine the characteristics of the patients with diverticulitis and pneumoperitoneum, and to evaluate their clinical course under medical nonoperative treatmet. Material and methods: Retrospective review of a prospectively set database. We evaluated the incidence of diverticulitis and pneumoperitoneum at the Shaio Clinic Foundation, Bogotá, Colombia, in the period October 2014 and October 2015, and additionaly described the outcomes with the medical management. Results: Among 60 patients with the diagnosis of diverticulitis, three had pneumoperitoneum (incidence of 5%) with no evidence of abdominal collections or free fluid in the peritoneal cavity. The three patients were managed with conservative antibiotic treatment, ending without short term mortality and no need of surgical intervention during their hospital stay. Conclusion: The incidence of diverticulitis and pneumoperitoneum without collections or free liquid is considerable. We believe that in select patients the conservative management should be the first line of treatment with a low rate of morbidity and mortality.

Keywords : diverticulum; colon; diverticulitis; pneumoperitoneum; therapy.

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