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  • Title: [Perforated diverticulitis of the colon. Problems of diagnosis and surgical tactics].
    Author: Balducci D, Pancaldi R, Borgo G, Chiodaroli R, Procino M, Postiglione V, Bruni GC.
    Journal: Minerva Chir; 1989 Sep 30; 44(18):1995-2000. PubMed ID: 2616001.
    Abstract:
    Perforated diverticulitis of the large bowel is a frequent observation in surgical practice. There is, however, no standard attitude to the procedures to be adopted: the only fixed point is the abandonment of straightforward colostomy and drainage. A series of 16 cases of perforated diverticulitis of the large bowel operated on in emergency and treated with various procedures, i.e. 8 Hartmann resections, 6 Paul-Mikulicz operations, 2 ideal colectomies, 2 colostomies and drainage. The observations made permit a number of considerations: 1) "ideal colectomy" is undoubtedly the best intervention providing the patient presents an early NPT and a temporary colostomy has been made to protect the anastomosis; 2) the rupture of a single diverticulum suggests the Paul-Mikulicz operation and it can be treated at a later stage by straightforward closure; 3) rupture of a diverticulum within the framework of extended diverticular involvement suggests Hartmann's resection; 4) colostomy and drainage should be abolished for its poor results and can be kept for patients in very serious condition.
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