Javier Nieto, MD, Tara Martinez, DO, Eric M Haas, MD FACS FASCRS. Division of Elective General Surgery, Department of Surgery, The University of Texas Medical School at Houston, Houston, TX
The proposed purpose of laparoscopic colonic lavage for the management of acute perforated diverticulitis in a patient presenting with generalized peritonitis is to provide safe and feasible treatment with the avoidance of the high morbidity and mortality rates associated with an emergent open surgical resection. We report a case of a 53-year-old male who presented with diffuse abdominal pain and a recent episode of uncomplicated diverticulitis managed medically with oral antibiotics. An outside CT scan was performed with findings concerning for perforated diverticulitis. Physical examination was significant for generalized peritonitis. We performed a laparoscopic colonic lavage with primary repair of a sigmoid colon perforation with overlay of an epiploic appendage. Future considerations for this approach may include the development of a uniformed set of inclusion criteria, the identification of predictors of failure, and the evaluation of the feasibility of laparoscopic lavage serving as definitive treatment without the requirement for future resection.
Session Number: SS17 – Videos: Colon
Program Number: V023