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However, if it is not contained it leads to faecal contamination of the peritoneal cavity (faecal peritonitis) which is often fatal. The Hinchey classification – proposed by Hinchey et al . in 1978 [ 1 ] classifies a colonic perforation due to diverticular disease.
The risk of complications, such as peritonitis or perforation, is greater during the first episode of diverticulitis, and the risk reduces with each recurrence. People who are immunocompromised have a 5-fold increased risk of recurrence with complications, such as bowel perforation, compared to immunocompetent people.
Gastrointestinal perforation, also known as gastrointestinal rupture, [1] is a hole in the wall of the gastrointestinal tract. The gastrointestinal tract is composed of hollow digestive organs leading from the mouth to the anus. [3] Symptoms of gastrointestinal perforation commonly include severe abdominal pain, nausea, and vomiting. [2]
Complicated acute diverticulitis is distinguished from uncomplicated diverticulitis by the presence of abscess or colonic perforation. Chronic smoldering diverticulitis is caused by recurrent acute diverticulitis that does not respond to medical treatment but does not progress to complications such as abscess, peritonitis, enteric fistula, or ...
Diverticulitis is defined as diverticular disease with signs and symptoms of diverticular inflammation. Clinical features of acute diverticulitis include constant abdominal pain, localized abdominal tenderness in the left lower quadrant of the abdomen, nausea, vomiting, constipation or diarrhea, fever and leukocytosis .
Recurrent diverticulitis may required resection even in the absence of perforation. Bowel resection or repair is typically initiated earlier in patients with signs of infection, the elderly, immunocompromised, and those with severe comorbidities. [16] Peptic ulcer disease may cause perforation of the bowel but rarely requires bowel resection.
a. Localized or generalized peritonitis caused by perforation of the bowel secondary to the cancer b. Viable but injured proximal bowel that, in the opinion of the operating surgeon, precludes safe anastomosis c. Complicated diverticulitis [2] Use of the Hartmann's procedure initially had a mortality rate of 8.8%. [3]
A Meckel's diverticulum, a true congenital diverticulum, is a slight bulge in the small intestine present at birth and a vestigial remnant of the vitelline duct.It is the most common malformation of the gastrointestinal tract and is present in approximately 2% of the population, [1] with males more frequently experiencing symptoms.