Surgical management of acute sigmoid diverticulitis

Purpose: To determine the frequency of use of resection and primary anastomosis in the management of acute sigmoid diverticulitis at Royal Columbian Hospital. Methods: A retrospective chart review of all patients undergoing emergency surgery for acute sigmoid diverticulitis between 1989 and 2000 at the Royal Columbian Hospital, New Westminster, BC, was carried out in order to determine the frequency of resection and primary anastomosis. Patients who underwent bowel preparation were excluded. Results: Ninety-seven cases met the criteria. There were 33 cases of resection and primary anastomosis (34%). Five of these cases were protected with a proximal diverting stoma giving an incidence of 85% unprotected primary anastomosis in a group of patients undergoing emergency surgery for acute sigmoid diverticulitis. There was 1 anastomotic leak, 7 wound infections, and 3 deaths with an average length of stay of 9 days. Conclusions: The practice of resection and primary anastomosis for acute sigmoid diverticulitis at the Royal Columbian Hospital has an acceptable morbidity and mortality. (C) 2002 Excerpta Medica, Inc. All rights reserved.