Allgemein- und Viszeralchirurgie up2date, Table of Contents Allgemein- und Viszeralchirurgie up2date 2017; 11(03): 233-244DOI: 10.1055/s-0043-104195 Unterer Gastrointestinaltrakt, Koloproktologie Georg Thieme Verlag KG Stuttgart · New York Divertikulose und Divertikelkrankheit des Kolons Christoph Holmer , Martin E. Kreis Recommend Article Abstract Buy Article All articles of this category Etwas 10 – 20% der Patienten mit einer Divertikulose entwickeln im Laufe ihres Lebens eine akute Divertikulitis. Epidemiologische Daten belegen eine steigende Hospitalisierungsrate sowie einen überproportionalen Anstieg der Inzidenz bei jungen Patienten. Bemerkenswert ist zudem, dass potenziell tödliche Komplikationen wie die Divertikelperforationen stetig zugenommen haben. Dieser Beitrag erläutert die stadiengerechte Therapie der Divertikelkrankheit. Schlüsselwörter SchlüsselwörterDivertikulose - Divertikulitis - Simgaresektion - konservative Therapie - Divertikulitiskomplikationen Full Text References Literatur 1 Jun S, Stollmann N. Epidemiology of diverticular disease. Best Pract Res Clin Gastroenterol 2002; 16: 529-542 2 Fong SS, Tan EY, Foo A. et al. The changing trend of diverticular disease in a developing nation. Colorectal Dis 2011; 13: 312-316 3 Etzioni DA, Mack TM, Beart jr. RW. et al. Diverticulitis in the United States: 1998–2005: changing patterns of disease and treatment. Ann Surg 2009; 249: 210-217 4 Humes DJ, Solaymani-Dodaran M, Fleming KM. et al. A population-based study of perforated diverticular disease incidence and associated mortality. Gastroenterology 2009; 136: 1198-1205 5 Ritz JP, Lehmann KS, Frericks B. et al. Outcome of patients with acute sigmoid diverticulitis: multivariate analysis of risk factors for free perforation. Surgery 2011; 149: 606-613 6 Lewis M. NDSG. Bleeding colonic diverticula. J Clin Gastroenterol 2008; 42: 1156-1158 7 Toorenvliet BR, Bakker RF, Breslau PJ. et al. Colonic diverticulitis: a prospective analysis of diagnostic accuracy and clinical decision-making. Colorectal Dis 2010; 12: 179-186 8 Leifeld L, Germer CT, Böhm S. et al. S2k-Leitlinie Divertikelkrankheit/Divertikulitis. Z Gastroenterol 2014; 52: 663-710 9 Tack D, Bohy P, Perlot I. et al. Suspected acute colon diverticulitis: imaging with low-dose unenhanced multi-detector row CT. Radiology 2005; 237: 189-196 10 Kircher MF, Rhea JT, Kihiczak D. et al. Frequency, sensitivity, and specificity of individual signs of diverticulitis on thin-section helical CT with colonic contrast material: experience with 312 cases. AJR Am J Roentgenol 2002; 178: 1313-1318 11 Wolff BG, Ready RL, MacCarty RL. et al. Influence of sigmoid resection on progression of diverticular disease of the colon. Dis Colon Rectum 1984; 27: 645-647 12 Benn PL, Wolff BG, Ilstrup DM. Level of anastomosis and recurrent colonic diverticulitis. Am J Surg 1986; 151: 269-271 13 Vermeulen J, Lange JF. Treatment of perforated diverticulitis with generalized peritonitis: past, present, and future. World J Surg 2010; 34: 587-593 14 Oberkofler CE, Rickenbacher A, Raptis DA. et al. A multicenter randomized clinical trial of primary anastomosis or Hartmannʼs procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg 2012; 256: 819-826 15 Constantinides VA, Herriot A, Remzi F. et al. Operative strategies for diverticular peritonitis: a decision analysis between primary resection and anastomosis versus Hartmannʼs procedures. Ann Surg 2007; 245: 94-103 16 Ceresoli M, Coccolini F, Montori G. et al. Laparoscopic lavage versus resection in perforated diverticulitis with purulent peritonitis: a meta-analysis of randomized controlled trials. World J Emerg Surg 2016; 11: 42 17 Sohn M, Agha A, Heitland W. et al. Damage control strategy for the treatment of perforated diverticulitis with generalized peritonitis. Tech Coloproctol 2016; 20: 577-583 18 Kafka-Ritsch R, Birkfellner F, Perathoner A. et al. Damage control surgery with abdominal vacuum and delayed bowel reconstruction in patients with perforated diverticulitis Hinchey III/IV. J Gastrointest Surg 2012; 16: 1915-1922 19 McGuire HH. Bleeding colonic diverticula: a reappraisal of natural history and management. Ann Surg 1994; 220: 653-656 20 Raskin JB, Kamm MA, Jamal MM. et al. Mesalamine did not prevent recurrent diverticulitis in phase 3 controlled trials. Gastroenterology 2014; 147: 793-802