Download PDF
Lege artis - Das Magazin zur ärztlichen Weiterbildung 2015; 5(4): 242-249
DOI: 10.1055/s-0040-100070
Fachwissen
Titelthema: Divertikelkrankheit des Kolons
© Georg Thieme Verlag Stuttgart · New York

Divertikelkrankheit des Kolons – Diagnostik und Therapie

Friederike Eisner
,
Philipp Horvath
,
Marty Zdichavsky
,
Alfred Königsrainer
,
Jörg Glatzle
Further Information

Publication History

Publication Date:
22 September 2015 (online)

Also available at
    Permissions and Reprints

Abstract

Die Divertikelkrankheit des Kolons gehört zu den häufigsten Erkrankungen des Gastrointestinaltrakts. Eine kürzlich erschienene konsensbasierte Leitlinie setzt neue Akzente bei der Behandlung der Erkrankung. So hat der Stellenwert interventioneller Verfahren zugenommen, auch das Paradigma einer generellen Indikation zur Resektion nach dem zweiten Entzündungsschub wurde verlassen. Der folgende Artikel fasst Diagnostik und Therapie unter Berücksichtigung der aktuellen Leitlinie zusammen.

Schlüsselwörter:

Divertikelkrankheit - Divertikulitis - Divertikelblutung - Divertikulose - Sigmaresektion

Ergänzendes Material

 

  • Literatur

  • 1 S2k-Leitlinie Divertikelkrankheit/Divertikulitis. Z für Gastroenterol 2014; 52: 663-710
    Google Scholar
  • 2 Golder M, Ster IC, Babu P et al. Demographic determinants of risk, colon distribution and density scores of diverticular disease. World J Gastroenterol WJG 2011; 17: 1009-1017
    Google Scholar
  • 3 Blachut K, Paradowski L, Garcarek J. Prevalence and distribution of the colonic diverticulosis. Review of 417 cases from Lower Silesia in Poland. Romanian J Gastroenterol 2004; 13: 281-285
    Google Scholar
  • 4 Manousos ON, Truelove SC, Lumsden K. Prevalence of colonic diverticulosis in general population of Oxford area. BrMed J 1967; 3: 762-763
    Google Scholar
  • 5 Etzioni DA, Mack TM, Beart RW, Kaiser AM. Diverticulitis in the United States 1998–2005: changing patterns of disease and treatment. Ann Surg 2009; 249: 210-217
    CrossrefGoogle Scholar
  • 6 Hansen O, Stock W. Prophylaktische Operation bei der Divertikelkrankheit des Kolons – Stufenkonzept durch exakte Stadieneinteilung. LangenbecksArchChir 1999; 115
    Google Scholar
  • 7 Hinchey EJ, Schaal PG, Richards GK. Treatment of perforated diverticular disease of the colon. AdvSurg 1978; 12: 85-109
    Google Scholar
  • 8 Zuckerman GR, Prakash C. Acute lower intestinal bleeding. Part II: etiology, therapy, and outcomes. GastrointestEndosc 1999; 49: 228-238
    Google Scholar
  • 9 Niikura R, Nagata N, Yamada A et al. Recurrence of colonic diverticular bleeding and associated risk factors. Colorectal Dis Off J AssocColoproctology G B Irel 2012; 14: 302-305
    Google Scholar
  • 10 Siewert B, Tye G, Kruskal J et al. Impact of CT-guided drainage in the treatment of diverticular abscesses: size matters. AJR Am J Roentgenol 2006; 186: 680-686
    CrossrefGoogle Scholar
  • 11 Poncet G, Heluwaert F, Voirin D et al. Natural history of acute colonic diverticular bleeding: a prospective study in 133 consecutive patients. Aliment PharmacolTher 2010; 32: 466-471
    CrossrefGoogle Scholar
  • 12 So JB, Kok K, Ngoi SS. Right-sided colonic diverticular disease as a source of lower gastrointestinal bleeding. Am Surg 1999; 65: 299-302
    Google Scholar
  • 13 Tan K-K, Liu JZ, Shen SF, Sim R. Emergency surgery in colonic diverticulitis in an Asian population. Int J Colorectal Dis 2011; 26: 1045-1050
    CrossrefGoogle Scholar
  • 14 Schuetz A, Jauch KW. Lower gastrointestinal bleeding: therapeutic strategies, surgical techniques and results. LangenbecksArchSurgDtsch Ges Für Chir 2001; 386: 17-25
    Google Scholar
  • 15 Matsushima K. Management of right-sided diverticulitis: A retrospective review from a hospital in Japan. Surg Today 2010; 40: 321-325
    CrossrefGoogle Scholar
  • 16 Fang J-F, Chen R-J, Lin B-C et al. Aggressive resection is indicated for cecal diverticulitis. Am J Surg 2003; 185: 135-140
    CrossrefGoogle Scholar
  • 17 Constantinides VA, Tekkis PP, Athanasiou T et al. Primary resection with anastomosis vs. Hartmann's procedure in nonelective surgery for acute colonic diverticulitis: a systematic review. Dis Colon Rectum 2006; 49: 966-981
    CrossrefPubMedGoogle Scholar
  • 18 Oberkofler CE, Rickenbacher A, Raptis DA et al. A multicenter randomized clinical trial of primary anastomosis or Hartmann's procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg 2012; 256: 826-827
    Google Scholar
  • 19 Vermeulen J, Coene PPLO, Van Hout NM et al. Restoration of bowel continuity after surgery for acute perforated diverticulitis: should Hartmann's procedure be considered a one-stage procedure?. Colorectal Dis Off J AssocColoproctology G B Irel 2009; 11: 619-624
    Google Scholar
  • 20 Alamili M, Gögenur I, Rosenberg J. Acute complicated diverticulitis managed by laparoscopic lavage. Dis Colon Rectum 2009; 52: 1345-1349
    CrossrefGoogle Scholar
  • 21 Toorenvliet BR, Swank H, Schoones JW, Hamming JF, Bemelman WA et al. Laparoscopic peritoneal lavage for perforated colonic diverticulitis: a systematic review. Colorectal Dis Off J AssocColoproctology G B Irel 2010; 12: 862-867
    Google Scholar
  • 22 Afshar S, Kurer MA. Laparoscopic peritoneal lavage for perforated sigmoid diverticulitis. Colorectal Dis Off J AssocColoproctology G B Irel 2012; 14: 135-142
    Google Scholar
  • 23 Angenete E, Thornell A, Burcharth J et al. Laparoscopic Lavage Is Feasible and Safe for the Treatment of Perforated Diverticulitis With Purulent Peritonitis: The First Results From the Randomized Controlled Trial DILALA. Ann Surg 2014;
    Google Scholar
  • 24 Swank HA, Vermeulen J, Lange JF et al. The ladies trial: laparoscopic peritoneal lavage or resection for purulent peritonitis and Hartmann's procedure or resection with primary anastomosis for purulent or faecal peritonitis in perforated diverticulitis (NTR2037). BMC Surg 2010; 10: 29-29
    CrossrefGoogle Scholar