[Operative mortality in diverticular sigmoiditis].

From 1984 to 1993, 200 patients (mean age 68 years) were hospitalized for complicated diverticulosis of the colon. Hospitalization was motivated in 81 patients for a programmed procedure (40%), by an acute complication requiring emergency surgery in 56 (29%) and by acute complication treated medically in 63 (31%). Among the 81 electively operated patients, one died post-operatively. For the 56 patients operated in an emergency situation, there were 8 post-operative deaths (14%). Six of the 8 deaths occurred in patients over 80 years. The natural history of colonic diverticulosis suggests that it would be logical to operate those patients with two episodes of sigmoiditis of those who have clinical manifestations (47 cases in our series). The other indication for planned surgery are colonic stenosis (17 cases), sequellae of abscesses (16 cases) and fistulae (11 cases). In patients with peritonitis and pelvi-peritonitis (35 cases) for whom exeresis is not a technical risk, it appears to be preferable to colostomy with drainage. Abscesses should be drained under ultrasonic or scan control. Finally, patients with massive haemorrhage should have an emergency angiography to guide the colectomy.