Diverticulitis is an inflammation of tiny pouches on the inner lining of the digestive tract known as diverticula. Diverticulitis may cause sudden, severe pain located in the lower left side of the abdomen as well as fever, nausea, constipation, diarrhea and in rare cases rectal bleeding. Physicians commonly treat diverticulitis with antibiotics, pain medications and a liquid diet. However, in cases where an abscess or perforation occurs, surgery may be the only option.
Drainage of Abscess
In diverticulitis, abscesses may form when the diverticula become infected and fill with pus. Physicians may need to drain the abscess surgically to allow it to heal. Physicians perform a surgical drainage by inserting a needle through the skin, which they guide by ultrasound or computerized tomography. They then place a catheter into the abscess to allow it to drain. The catheter often stays in place during the healing process to allow for continual drainage. Doctors also prescribe antibiotics. After the patient has recovered, a bowel resection may be necessary.
Primary Bowel Resection
During a bowel resection, physicians attempt to remove the diseased portion of the bowel while still allowing the patient to have normal bowel movements. Primary bowel resections are performed in a hospital under general anesthesia. During the procedure, the surgeon removes the diseased section of colon and then reconnects the colon to the rectum. A primary bowel resection can be done using either an open incision or a laparoscopic procedure in which the abdomen remains closed, with cameras inserted through small incisions. Laparoscopic surgery generally has a faster recovery time. The risks of a bowel resection include damage to nearby organs, wound infections, bulging tissue through the incision, scar tissue and the reopening of the wound.
Colostomy
In cases where large amounts of inflammation exist, surgeons may not be able to rejoin the colon to the rectum and will instead perform a colostomy. During a colostomy, surgeons create an opening in the abdominal wall called a stoma. The healthy part of the colon is then connected to the stoma, and waste passes through the opening into a bag. A colostomy may be temporary or permanent. After several months, if the inflammation has sufficiently healed, physicians may perform a second procedure to reconnect the colon and rectum and close the stoma on the abdominal wall.
