Surgical Treatment of Diverticulitis

In the past 5 1/2 years, 71 patients with diverticulitis were operated on--20.8% of all cases of diverticulitis admitted to the Bronx Municipal Hospital Center. Operative mortality was 22%, primarily because of delayed diagnosis, inadequate surgery, and a high incidence of associated disease. Only 20% of patients operated on had a previous history of diverticular disease. Hemorrhage was the indication for surgery in 16 cases; in this situation, a subtotal colectomy in one stage is the operation of choice. Perforation was the indication in 47 cases, eight of these being acute and with free air under the diaphragm. In cases with peritoneal contamination, a two-stage procedure (removing the diseased portion of colon at stage one) is advocated. Colostomy without drainage, or closure of a free perforation, is condemned.