2019 年 44 巻 2 号 p. 161-166
Objectives: The present study was performed to examine operative cases of perforated diverticulitis and to consider the corresponding treatments.
Methods: In the 10-year period from January 2007 to December 2016, 20 cases of perforated sigmoid diverticulitis were treated surgically in our hospital. We examined the background factors, physical findings, preoperative diagnoses, surgical findings, and postoperative courses.
Results: Twenty patients with sigmoid colon diverticulitis, eleven males and nine females with a median age of 67.5 years (25 to 87 years), were included in the analysis. Preoperative complications included chronic kidney failure, including post-transplantation failure in 4 cases (20%), among others. Surgery was performed using open methods, including 15 patients who underwent the Hartmann procedure and 5 patients who underwent colon resection or suture closure with stoma construction. Among the postoperative complications, stoma dropout, deep venous thrombosis with pelvic abscess formation, pneumonia, and wound dehiscence were detected in one case each. Postoperative polymyxin-direct hemoperfusion (PMX-DHP) was effective in 2 cases (10%). No deaths occurred.
Conclusions: For perforated sigmoid diverticulitis, we performed colon resection or suture closure with stoma construction by open methods. The postoperative course was relatively favorable.
