Perforated Diverticulitis with Generalized Peritonitis: Low Stoma Rate Using a “Damage Control Strategy”

Sohn, Maximilian; Iesalnieks, Igors; Agha, Ayman; Steiner, Phillip; Hochrein, Alfred; Pratschke, Johann; Ritschl, Paul Viktor; Aigner, Felix

doi:10.1007/s00268-018-4585-y

Cited by 38 publications

(45 citation statements)

References 44 publications

(40 reference statements)

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“…Free fluid has been suggested to be another surrogate marker, but it is frequently found in uncomplicated diverticulitis as well, rendering the use as a surrogate marker for complicated disease difficult [84]. There are no randomized trials that involve nonsurgical or nonresectional treatment for faecal peritonitis [116][117][118][119]. Some patient series have investigated laparoscopic closure of a perforation combined with laparoscopic lavage but there is little evidence to support this practice [120].…”

Section: Should a High-fibre Diet Be Recommended Following An Episodementioning

confidence: 99%

“…Some patient series have investigated laparoscopic closure of a perforation combined with laparoscopic lavage but there is little evidence to support this practice [120]. There are some studies suggesting damage control with a second look within a couple of days [116,121]. Neither are established techniques.…”

Section: Should a High-fibre Diet Be Recommended Following An Episodementioning

confidence: 99%

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European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Schultz

Azhar

Binda³

et al. 2020

Colorectal Disease

168

214

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Aim The goal of this European Society of Coloproctology (ESCP) guideline project is to give an overview of the existing evidence on the management of diverticular disease, primarily as a guidance to surgeons. Methods The guideline was developed during several working phases including three voting rounds and one consensus meeting. The two project leads (JKS and EA) appointed by the ESCP guideline committee together with one member of the guideline committee (WB) agreed on the methodology, decided on six themes for working groups (WGs) and drafted a list of research questions. Senior WG members, mostly colorectal surgeons within the ESCP, were invited based on publication records and geographical aspects. Other specialties were included in the WGs where relevant. In addition, one trainee or PhD fellow was invited in each WG. All six WGs revised the research questions if necessary, did a literature search, created evidence tables where feasible, and drafted supporting text to each research question and statement. The text and statement proposals from each WG were arranged as one document by the first and last authors before online voting by all authors in two rounds. For the second voting ESCP national representatives were also invited. More than 90% agreement was considered a consensus. The final phrasing of the statements with < 90% agreement was discussed in a consensus meeting at the ESCP annual meeting in Vienna in September 2019. Thereafter, the first and the last author drafted the final text of the guideline and circulated it for final approval and for a third and final online voting of rephrased statements. Results This guideline contains 38 evidence based consensus statements on the management of diverticular disease. Conclusion This international, multidisciplinary guideline provides an up to date summary of the current knowledge of the management of diverticular disease as a guidance for clinicians and patients.

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Section: Should a High-fibre Diet Be Recommended Following An Episodementioning

confidence: 99%

Section: Should a High-fibre Diet Be Recommended Following An Episodementioning

confidence: 99%

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Schultz

Azhar

Binda³

et al. 2020

Colorectal Disease

168

214

View full text Add to dashboard Cite

show abstract

“…A doença diverticular pode receber outra classificação, baseada na sintomatologia, em complicada ou não complicada. No paciente relatado, sua doença foi classificada como complicada, pois foram observados abscessos pericólicos, obstruções e perfuração da diverticulite; tais achados são considerados raros nos casos descritos na literatura 12 .…”

Section: Discussionunclassified

Lesão pseudotumoral de colo direito um desafio diagnóstico: relato de caso

et al. 2019

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ResumoCom o crescente envelhecimento populacional, a doença diverticular e suas complicações podem apresentar porcentagens cada vez maiores. A presença de inflamação e infecção dos divertículos é denominada diverticulite, que pode ocorrer em todo o cólon. O sigmóide é a região mais comumente acometida e, dificilmente a doença ocorre abaixo da reflexão peritoneal. O presente artigo objetiva relatar um caso raro de abdome agudo perfurativo causado por uma diverticulite pseudotumoral, que simulava neoplasia infiltrativa do cólon direito. O processo inflamatório foi classificado como complicado, pois foram observados abscessos pericólicos, obstruções e perfuração dos divertículos. À laparotomia, tais lesões mostraram-se indistinguíveis de lesões neoplásicas, sendo necessária abordagem cirúrgica com ressecção ampliada, cujo objetivo final foi realizar a terapêutica curativa das lesões independente da sua etiologia. Right colon pseudotumoral diverticulitis -a challenge diagnostic: case reportDiverticulite pseudotumoral de cólon direito -um desafio diagnóstico: relato de caso Abstract With increasing population aging, diverticular disease and its complications may present increasing percentages. The presence of inflammation and infection of the diverticula is called diverticulitis, which can occur throughout the colon. The sigmoid is the most commonly affected region and, rarely, the disease occurs below the peritoneal reflex. The present article aims to report a rare case of acute piercing abdomen caused by a pseudotumoral diverticulitis, which simulated right colon infiltrative neoplasia. The inflammatory process was classified as complicated because pericolic abscesses, obstructions and perforation of the diverticula were observed. At laparotomy, such le-sions were indistinguishable from neoplastic lesions, and a surgical approach with en-larged resection was necessary, whose ultimate objective was to perform the curative therapy of the lesions regardless of their etiology. Como citar esse artigo. Iraha, R.A.C.; Guerra, M.J.C.; Bastos, A.P.; Sodré, P.S.; Passos, M.A.T; Maia, L.M.O. Diverticulite pseudotumoral de cólon direito -um desafio diagnóstico: relato de caso. Revista de Saúde. 2019 Jan./Jun.; 10 (1): 55-60.

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“…Clinical significance was further found in the secondary endpoints, morbidity after ostomy reversal, organ/space surgical site infection after emergency surgery, reoperation and non‐reversal of the ostomy. The latter showed a 31.8% stoma rate at the end of the observational period in the NRR group compared to 13.6% in the PRA group, which is comparable to the stoma rate of 17% in our small multicenter series of the damage control concept (DC) with delayed anastomosis with or without defunction .…”

mentioning

confidence: 99%

“…Unfortunately, too little attention has been paid so far to alternative interventions with delayed reconstruction like damage control surgery .…”

mentioning

confidence: 99%

Editor's choice

Aigner¹

2018

Colorectal Disease

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Perforated Diverticulitis with Generalized Peritonitis: Low Stoma Rate Using a “Damage Control Strategy”

Abstract: The use of the Damage Control strategy leads to a comparatively low stoma rate in patients suffering from perforated diverticulitis with generalized peritonitis.

Cited by 38 publications

References 44 publications

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

European Society of Coloproctology: guidelines for the management of diverticular disease of the colon

Lesão pseudotumoral de colo direito um desafio diagnóstico: relato de caso

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