Diverticulitis Surgery

 

Diverticulitis that fails to clears up after a few days of treatment with antibiotics indicates the presence of abscessesinfected areas filled with pus that may swell and destroy tissueor small holes called perforations in the colon. Both abscesses and perforations can be treated with surgery.

One type of surgical procedure involves simply draining the abscess using a needle and a small tube known as a catheter. In this type of surgical procedure, the doctor inserts the needle through the skin into the abscess and drains the fluid out through the catheter. This procedure is known as percutaneous catheter drainage.

Large abscesses can create a serious problem called peritonitis if the infection leaks into the abdominal cavity and contaminates areas outside the colon. Peritonitis requires immediate surgery to clean the abdominal cavity and remove the damaged part of the colon. Without surgical intervention, peritonitis can be fatal.

Surgery is also called for when an infection caused by diverticulitis has spread outside the colon and colon tissue has adhered to the tissue of other organs, thus forming the abnormal tissue connections known as fistulas.

Surgery for diverticulitis entails removing the abscessed and fistulous parts of the colon.

Diverticulitis surgery is generally necessary when:

1A partial blockage or narrow place called a stricture has developed in the colon

2 Attacks of diverticulitis are repeated and severe

3 A high risk of complications exists if surgery is not performed

4 Patients experience repeated bleeding from the colon

5 There is a perceived risk or likelihood of cancer

About 15% to 20% of initial attacks of diverticulitis require surgery because of perforation or bowel obstruction or because medical treatment does not stop the infection. Ninety-nine percent of diverticulitis surgical patients who can schedule their surgeries in advance survive. When surgery is performed as an emergency after a perforation into the abdominal cavity has caused peritonitis, about 70% of all patients survive.

Surgical treatment for diverticulitis is known as colectomy in which the healthy parts of the colon are surgically reconnected after the surgeon removes the diseased parts such as abscesses and fistulas.

More than one surgery for diverticulitis may be necessary, depending on the severity and nature of the symptoms. When multiple surgeries are necessary, the patient usually has a surgical procedure known as a colostomy, in which the upper part of the intestine is sewn to an opening made in the skin of the abdomen, performed between the diverticulitis surgeries. The patient then passes stool through this opening into a disposable bag attached to the body. The colostomy is usually removed and the intestine reconnected at a later time.

People who have experienced mild, brief attacks of diverticulitis should try making long-term changes in their diets to include more fiber and reduce pressure on their diverticula, and with this one change, a certain percentage of sufferers are able to avoid surgical intervention. However, when multiple and acute attacks of diverticulitis occur, surgery may be the most appropriate choice.