Nonoperative management of complicated diverticular disease Journal Article
| Authors: | Schaffzin, D. M.; Wong, W. D. |
| Article Title: | Nonoperative management of complicated diverticular disease |
| Abstract: | The complications of diverticular disease of the colon can be divided into those related to inflammatory conditions (diverticular abscess, fistula, and perforation) and those related to noninflammatory conditions (lower gastrointestinal hemorrhage and noninflammatory stricture or obstruction). Nonoperative management of uncomplicated diverticulitis includes bowel rest and antibiotics. For abscesses, percutaneous drainage by radiologic guidance often turns complicated diverticulitis to an uncomplicated condition. In very select instances, fistulas or even perforation may be managed without operation. Strictures may be dilated or stented. Diverticular hemorrhage may be controlled with colonoscopic and angiographic techniques. For colonoscopy, these include cautery, epinephrine injection, and endoclips. For angiography, these include arterial infusion of vasopressin and selective embolization of bleeding vessels. For both diverticulitis and diverticular bleeding, these nonoperative therapeutic modalities may be utilized as a bridge to surgery, or in select instances as a definitive therapy obviating the need for surgery. |
| Keywords: | adult; treatment outcome; antibiotic agent; antibiotic therapy; review; artificial embolism; gastrointestinal hemorrhage; bleeding; colonoscopy; ciprofloxacin; stent; colon perforation; gentamicin; doxycycline; cotrimoxazole; metronidazole; angiography; percutaneous drainage; vasopressin; stomach obstruction; inflammatory disease; clindamycin; abscess; sultamicillin; adrenalin; colon fistula; ampicillin; amoxicillin plus clavulanic acid; diverticulitis; cauterization; colon diverticulosis; nonoperative management; human; diverticular bleeding; cefotetan; cefoxitin |
| Journal Title: | Clinics in Colon and Rectal Surgery |
| Volume: | 17 |
| Issue: | 3 |
| ISSN: | 1531-0043 |
| Publisher: | Thieme Publishing |
| Date Published: | 2004-08-01 |
| Start Page: | 169 |
| End Page: | 176 |
| Language: | English |
| DOI: | 10.1055/s-2004-832698 |
| PROVIDER: | scopus |
| PMCID: | PMC2780064 |
| PUBMED: | 20011272 |
| DOI/URL: | |
| Notes: | Clin. Colon Rectal Surg. -- Cited By (since 1996):2 -- Export Date: 16 June 2014 -- CODEN: CCRSC -- Source: Scopus |
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