DIVERTICULITIS OF THE SIGMA UNDER IMMUNOS UPPRESSION

In a retrospective study we evaluated the data of 92 patients (41 wome n, 51 men, age median: 63 years) with diverticulitis of the sigma who were treated surgically in our clinic from January 1986 till December 1992. Twelve patients (13 %) suffered from suppression of the immune s ystem due to a corticoid therapy (n = 3), chemotherapy (n = 1), combin ation of corticoid therapy and chemotherapy (n = 1), combination of ch emotherapy and azathioprine, leucopenia due to carbimazole therapy as a side effect (n = 1) and immunosuppression with prednisone, azathiopr ine and cyclosporine after renal and heart transplantations (n = 5). T he therapy was Hartmann's procedure in 5 patients, drainage and loop c olostomy in one patient, sigma resection with primary anastomosis with out a protective enterostomy in 5 patients and with a loop ileostomy i n one patient. One patient died in the early postoperative course. Sig ma diverticulitis in immunosuppressed patients is a well-known problem especially in large clinics with organ transplantation units. In cont rast to reports from up to the eighties we found no significant differ ence in the postoperative morbidity and mortality after surgical treat ment of acute sigma diverticulitis in immunosuppressed patients compar ed to non immunosuppressed patients.