Abstract

Precise criteria were prospectively used to indicate surgery in patients with diverticular disease of the colon: a) anatomical deformity of the sigmoid (ADS), including stenosis and fistulae with presence of contrast media extraluminally; b) recurrent acute diverticulitis (RAD); c) prior diverticulitis with perforation (DP) and d) recurrent GI bleeding (GIB). 42 patients were operated on according to these criteria, from 1978 to 1988, 26 males and 16 females, with a mean age of 61 years (range 31 to 93). ADS was the indication in 22 patients (52%), with fistulae present in 9. RAD was the indication in 16 patients (37%), DP in 9 patients (21%) and GIB in 5%. All patients were submitted to either ample sigmoid resection or left hemicolectomy. All patients were followed, with a mean of 43 months for the series. Only 1 patient died after surgery from pulmonary embolism. Late clinical evaluation revealed absence of preoperative symptoms and signs. We feel that surgical treatment of diverticular disease of the colon is warranted with the criteria described, with good immediate and longterm results.