OPERATIVE MORTALITY IN COMPLICATED COLONI C DIVERTICULOSIS

Between 1984 and 1993, 200 patients (mean age, 68 years) were hospital ized with a diagnosis of complicated colonic diverticulosis. Eighty-on e patients (40%) were hospitalized for elective surgery, 56 (29%) pati ents were hospitalized for acute symptoms and treated surgically, and 63 patients (31%) were hospitalized for acute symptoms and treated con servatively. There was one postoperative death among the 81 patients w ho had elective surgery, and 8 (14%) postoperative deaths among 56 pat ients who had emergent surgery, including 6 in patients older than 80 years. Surgery is warranted in patients with a history of two or more attacks of inflammation or with current symptoms (47 patients). The ot her indications for elective surgery are colonic stenosis (17 patients ), residual intra-abdominal abscesses (16 patients) and fistula (11 pa tients). For peritonitis or pelvic peritonitis (35 patients) resection , if technically possible, seems preferable over colostomy and drainag e. Diverticular abscesses require percutaneous drainage. In severe ble eding, angiography helps which part of the colon should be removed.