The acute diverticulitis in emergency

Introduction: Treatment of acute diverticulitis still remains complex and not univocal today, surgical mortality being between 5 and 45%. Methods: We have observe 76 patients with diagnosis of acute diverticulitis. In 61 cases the inflammatory and sub-occlusive symptomatology has been faced with medical therapy, with resolution of inflammatory symptomatology in 47 cases. In 14 patients the resolution of inflammatory symptomatology has been had but only partially of the sub-occlusive picture and therefore, it has been provided to surgical operation in election. 15 patients (9 male, 6 female) in an average time of 69.3 years, introduced a clinical picture of acute abdomen and therefore they have been undergone to surgical operation in emergency. Results: All the patients had been operated within the 24 h from the entry in the first aid; in 13 patients we have found a diverticular tumour, with diastasical perforation in 2 of us, while in 2 cases was present a diverticulum perforation. In all the patients we have executed a primary resection with manual anastomosis in double layer. We haven’t registered intra operating mortality only in 1 case we have had a anastomotical dehiscence, that have not needed of a re-operating. In 3 cases we have registered a wound infection treated with antibiotic therapy. Discussion: In our experience the adoption of an operating in an only time, when is not deferrable, seems to be the most suitable and the less expensive procedure. In the greater part of the cases is preferable to treat the patients, when possible.