Chirurgische Therapie der akuten Divertikulitis

Zusammenfassung.

Bei der Divertikelkrankheit lassen sich 3 Verlaufsformen unterscheiden: Die asymptomatische Divertikulose, die symptomatische und die komplizierte Divertikelkrankheit. Aus prognostischen Gründen kommt fast ausschließlich die komplizierte Verlaufsform für eine chirurgische Therapie infrage. Grundlegend für die Operationsindikation und operative Verfahrenswahl sind dabei die korrekte Einschätzung und Klassifizierung der Erkrankung. Das einzeitige Vorgehen ist dabei das anzustrebende Verfahren und sollte wenn möglich elektiv erfolgen. Bei Perforation und Peritonitis sind zusätzlich aktuelle Prinzipien der Peritonitis-Therapie zu berücksichtigen.

Surgical therapy of acute diverticulitis.

Diverticular disease can be classified into asymtomatic, symptomatic or complicated. Surgery is required only for complicated disease. Indication and operative strategy is based on a correct classification and staging. Primary anastomosis is the most usefull procedure in the therapy of acute diverticular disease and should be performed electively. Perforated disease with abdominal sepsis should include basic principles of peritonitis therapy.

Schlüsselwörter:

Divertikulitis - Divertikelkrankheit - Peritonitis - Perforation

Key words:

Diverticulitis - Diverticular disease - Peritonitis - Perforation

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