During the past 11 years, 22 cases of perforated colonic diverticulum have been treated in our department. The mean age of the patients was 53.8 years and ranged from 18 to 86 years.The cases were retrospectively analyzed to elucidate the clinical characteristics of perforated diverticulum.They were divided into two groups according to the site of perforation (right side: group 1, 13 cases, left side: group 2, 9cases). The mean age in group 2 was significantly older than in group 1.The site of perforation was located in the cecum in 8 of the 9 cases in group 1 and in the sigmoid colon in 8 of the 13 cases in group 2.Seven patients presented with free air in the abdominal cavity, and 6 of them were in group 2. In group 1, the site of perforation in the colon was resected, and the resected ends were reanastmosed in most cases.In contrast, Hartmann's procedure was the preferred operation in group 2.Although overall mortality was 23.8%, mortality in the cases that presented with free air was 50%.In group 1, acute appendicitis had to be ruled out, but the differential diagnosis was often difficult.Cases with free air in the abdomen should be surgically explored urgently on the assumption of a perforated diverticulum.

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