Surgical treatment of acute sigmoiditis

Virtually unknown at the beginning of the century, diverticulosis has becom e very prevalent in western countries. The natural history of the disease i s notable for its acute, sometimes recurrent, attacks of diverticulitis and the significant risk of serious complications: abscess, fistula, peritonit is. CT scanning preodminates in the diagnostic evaluation. It can provide b oth diagnostic and prognostic information. Most mild attacks of diverticuli tis respond well to medical therapy while surgical treatment is indicated i n the complicated forms of the disease. Surgical therapy has gradually evol ved from a complicated three stage approach to two-staged, single-staged, o r even minimally invasive procedures. The current trend is to intervene sur gically well after the resolution of the acute attack. To achieve this, lib eral use of percutaneous drainage of collections and medical treatment are advocated. The decision to perform prophylactic sigmoid resection must be b ased on a balance assessment of risk factors including age, severity of att acks and their recurrence.