Operative procedures

1. Single stage procedure. This procedure is usually performed as an elective procedure after resolution of the acute attack of diverticulitis. The segment containing inflamed diverticulum (usually sigmoid colon) is resected with primary anastomosis. A bowel prep is required.

2. Two stage procedure. This procedure is indicated for acute diverticulitis with obstruction or perforation with an unprepared bowel. The first stage consists of resection of the involved segment of colon, with end colostomy and either a mucous fistula or a Hartmann rectal pouch. The second stage consists of a colostomy take-down and reanastomosis after 2-3 months.

References: See page 195.

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