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Treatment

Authoring team

Treatment of perforated diverticular disease involves:

  • parenteral antibiotics
  • laparotomy with a generous midline incision to gain access to sites as distant as the splenic flexure and the pelvis
  • peritoneal toilet
  • diversion of the faecal stream and removal of diseased bowel is indicated if faecal peritonitis or squeezing the bowel causes gas or other matter to emerge from the inflamed region. Choices include:
    • primary resection of the perforated region with direct anastomosis
    • hemicolectomy with or without a defunctioning transverse colostomy for the proximal end
    • resection followed by Hartmann's procedure

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