Percutaneous drainage of a diverticular abscess can make colostomy unnecessary in selected cases.

Diverticular abscess is a common acute abdominal problem in patients over 50 years of age and may require single or multiple operations. Percutaneous drainage of the abscess may permit a single operation in selected patients, making a colostomy unnecessary. This approach is probably underutilized and should become the procedure of choice in selected patients with no other medical problems such as immunosuppression. We report two patients, including one with a fecal fistula, in whom percutaneous drainage converted a situation in which two operations, one with a colostomy, would have been required, to a single operation without a colostomy. This approach saves about $7,000 per patient. The avoidance of colostomy and the cost savings make this approach attractive in selected patients with diverticular abscesses.