New perspectives in the management of sigmoid diverticulitis

The sigmoid colon is the part of the large intestine, which most commonly i nvolved in diverticular disease due to its anatomical properties. Diverticu lar disease of the colon is being seen with increasing frequency mostly in western countries. Diverticulitis results from inflammation and subsequent perforation of a colonic diverticulum. Mild forms of diverticulitis usually present with gradually increasing symptoms from the lower left quadrant of the abdomen, whereas acute complicated disease is characterised by dramati c onset of abdominal pain, followed by fever within a few hours. The standa rd treatment for uncomplicated diverticulitis is bowel rest, with liquid di et or intravenous fluids in combination with antibiotics. Prophylactic rese ction is not to be recommended for patients with diverticular disease, but a high-fibre diet may afford protection by preventing further complications . Patients not responding to conservative treatment within the first 24 hou rs require further evaluation by computed tomography or ultrasonography. Fi stula formation and intestinal obstruction are indications, for surgical in tervention, although the frequent recurrent attacks, which commonly afflict these patients, are seldom associated with severe complications. Laparosco pic approach has been introduced in the diagnosis and definitive treatment of uncomplicated diverticulitis, with less morbidity and mortality rates, a nd hospitalisation of the patients and in these terms could be promising in the future.