1. Acute surgery for diverticulitis at Söder Hospital 2003-2004
Emil Pieniowski Medical Student
Lennart Boström MD, PhD
Söder Hospital, Karolinska Institutet,
Stockholm, Sweden

2. Background:
Söder hospital: An emergency hospital with a referral area of about people
Aims:
To study…
the preoperative condition of the patients
preoperative investigations made
performed operations
morbidity and mortality
…after acute surgery for diverticulitis

3. Material and methods Inclusion criterias: Acute surgery
K572 (Diverticula in the colon with perforation and abscess)
K573 (Diverticula in the colon without perforation or abscess)
Primary operation

4. Retrospective analysis
Material and methods
Retrospective analysis
61 patients
62% females
Mean age 67 years

5. Preoperative status Mean ASA-score 2,4 Mean max-values:
CRP of 183 mg/ml
LPK of 15,5 x 109/l
Mean: 132 mmHg; 8%< 100 mmHg
Mean 90 b/min; 26% > 100 b/min

6. Preoperative investigations
Plain X-ray 59%
CT 41%
Barium enema 21%
Ultrasound 11,5%
Contrast X-ray (small-bowel) 5%
MRI 3%
Colonoscopy 2%
_____________________
In 46% of the patients multiple
methods were used

7. Indications for surgery
Perforation 59%
Suspected appendicitis 15%
Large-bowel obstruction 13%
Small-bowel obstruction 10%
Fistulation 3%

8. *other than Hartmanns

9. 64% (n=39) of patients got a stoma*
*5 patients already had a stoma due to prior surgery

11. Postoperative complications, most common Morbidity 49%
Surgical:
Wound infection 15%
Incisional hernia 10%
Postoperative septicaemia 10%
Stoma complications 7%
Intra-abdominal abscesses 5%
Fistulation 5%
General:
Pneumonia 13%
Congestive heart failure 8%
AMI 5%

12. Other consequences Reoperation rate 10% Mean hospital stay: 12,7 days
23% in ICU

13. Mortality Mortality 8% (n=5) ________________________________
Mean age 83 years
Mean ASA-score 3,8
4 of 5: preoperative plain X-ray with pneumoperitoneum
2 of 5 had care in ICU

14. Conclusions Mainly eldery people, preferably females affected
Most common indication for acute surgery was perforation
Hartmanns operation was the commonest procedure
Hospital stay in the emergency hospital was less than two weeks
Low mortality
Deceased; older patients with high mean ASA-score, compared to survivors

15. That´s all…