Diagnostic lap or laparotomy in a suspected case of descending colon diverticulitis perforation
| Discussion in 'All Categories' started by Dr. Srikanth - May 17th, 2016 9:08 am. | |
Dr. Srikanth
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A 55 yr old male patient with suspected diverticular perforation. But no signs of peritonitis or obstruction. Can laparoscopy be an option or is it better to go ahead with laparotomy when the patient is fit |
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re: Diagnostic lap or laparotomy in a suspected case of descending colon diverticulitis perforation
by Dr R K Mishra -
May 17th, 2016
9:46 am
#1
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Dr R K Mishra
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Dear Dr Srikanth, In my opinion Diagnostic Laparoscopic is a better option. Even if there is perforation or early peritonitis then Laparoscopic lavage offers an alternative to the open surgery for patients with perforated diverticulitis with purulent peritonitis. |
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re: Diagnostic lap or laparotomy in a suspected case of descending colon diverticulitis perforation
by Dr Srikanth -
May 17th, 2016
11:39 pm
#2
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Dr Srikanth
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Thank you sir. I wil post the vedio of the procedure. |
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re: Diagnostic lap or laparotomy in a suspected case of descending colon diverticulitis perforation
by Dr. Vipul Rai -
May 18th, 2016
8:10 am
#3
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Dr. Vipul Rai
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What to do once after going inside we will find that it is perforation. |
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re: Diagnostic lap or laparotomy in a suspected case of descending colon diverticulitis perforation
by Dr R K Mishra -
May 18th, 2016
10:05 am
#4
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Dr R K Mishra
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Prophylactic sigmoid resection should be performed without colostomy by laparoscopy in all these patient with early perforation or impending perforation. However conversion rate is quite high if the peritonitis is delayed than 48 hour. |
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re: Diagnostic lap or laparotomy in a suspected case of descending colon diverticulitis perforation
by Dr Srikanth -
May 19th, 2016
12:10 am
#5
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Dr Srikanth
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Diagnostic laparoscopy was done. Localised peritonitis with plaques sealing off the gangreneous and perforated diverticulitis from descending colon. Rest of the anatomy examined. Converted to laparotomy . The left colon has shrunken and mobilisation of the colon was very difficult owing to obesity. Resection of 10 cm of colon done, proximal colostomy done. Distal end closed( hartmann s procedure). Today is 1 pod. Vitals are improving. Sepsis is resolving. Blood transfusion done. |
