PERFORATIVE COMPLICATION OF COLON DIVERTICULITIS : EVOLUTION OF SURGICAL TACTICS.

Abstract

The ideal treatment for perforative complication in diverticular disease of the colon is still now rather controversial.

Fundamental remains the simple and practical classification of Hinchey for perforated diverticulitis, especially for a meaningful evaluation of different experience. Without a common reference classification the percentage differences in mortality are completely devoid of scientific value.

From a “three stage” procedure the preferences are shifted towards a “two stage procedure”, thanks to the improvement of anesthetic and surgical modern facilities. The Hartmann procedure, performed not earlier than 4-6 months is the experience of the authors, but the ultimate choice is conditioned by the degree of peritoneal contamination.