The Surgical Treatment of Diverticulitis
The surgical problems presented in the treatment of diverticulitis do not parallel those of acute appendicitis in many cases. However, the differing opinions held by men of wide experience cannot be dismissed without serious thought.
Erdmann in 1932 reported a series of 71 cases of diverticulitis and stated that the acute condition of the abdomen presents but one solution to him and that is early operation. He believes that one should no more wait for resolution in an abdomen in the acute type of this disease than in an allied condition due to appendicitis or to suppurating tubes. However, he does not state the specific type of treatment in a given number of cases, and he does not state the mortality from the various procedures so that it is difficult to make a comparison with other series.
In reading case reports in the literature, one is impressed by the number in which exploratory operation was done during the acute phase of the disease with termination a few days later in death due to peritonitis. One is justified in wondering whether or not localization might have occurred in a certain percentage of these cases in a period of days and surgical intervention later might have been more safe. This condition calls for more individualization than does acute appendicitis, and while general rules may be formulated, each patient must be studied carefully.
One outstanding clinical fact is that diverticulitis is practically always confined to the sigmoid colon, even though the diverticula may. . .