Incidence, outcome, and proposed management of isolated abscesses complicating acute left-sided colonic diverticulitis. A prospective study of 140 patients
| Autor: | Patrick Ambrosetti, D Mirescu, John Robert, R. de Gautard, Adrien Rohner, F. Borst, J A Witzig |
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| Rok vydání: | 1992 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous Peritonitis Anastomosis Asymptomatic Diverticulitis Colonic Colonic Diseases Abdomen Medicine Humans Prospective Studies Abscess Prospective cohort study Aged business.industry Incidence Gastroenterology General Medicine Diverticulitis Middle Aged medicine.disease Combined Modality Therapy Colorectal surgery Surgery Anti-Bacterial Agents Treatment Outcome Acute Disease Drainage Female Radiology medicine.symptom business Tomography X-Ray Computed Pelvic Inflammatory Disease |
| Zdroj: | Diseases of the colon and rectum. 35(11) |
| ISSN: | 0012-3706 |
| Popis: | 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 intraabdominal 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. |
| Databáze: | OpenAIRE |
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