Pathology findings confirmed the diagnosis of severe and
perforated diverticulitis with necrosis of the abdominal wall.
Giuricin, V Girardi et al., "Subcutaneous emphysema, pneumomediastinum, pneumoretroperitoneum, and pneumoscrotum: unusual complications of acute
perforated diverticulitis," Case Reports in Radiology, vol.
Later, now a senior surgical registrar, I was reviewing cases of acute
perforated diverticulitis of the colon admitted to the old Radcliffe Infirmary, (now, like all 15 of the hospitals that I have worked in, closed down or pulled down).
Perforation is probably the most feared complication and the annual prevalence of perforated diverticulitis within a northern European population is currently thought to stand at 3.8 per 100,000 of the population, which is a figure that is increasing (16).
Historically, perforated diverticulitis was treated with a three-stage procedure consisting of faecal diversion with a stoma, resection of the diseased segment of bowel, followed by takedown of the stoma and restoration of intestinal continuity.
In the largest series in the literature to date, Myers et al reported 100 patients with perforated diverticulitis and generalised peritonitis.
The patient was a man in his 40s who had undergone a Hartmann's procedure for perforated diverticulitis and subsequent colostomy closure.
It has been shown that perforated diverticulitis with Hinchey grade 3 has at least a 90 percent success rate when treated with laparoscopic peritoneal lavage and drainage alone.
The clinical impression was that he had
perforated diverticulitis with intra-abdominal abscess, and he was immediately operated on.