Praxis
-
Despite modern therapeutical options,perforated sigma diverticulitis still represents a life-threatening disease. In terms of diagnostic and therapeutic proceeding, the covered perforation has to be distinguished from free perforation. Primary therapeutic objective is the excision of the inflamed bowel segment to avoid abdominal sepsis. ⋯ Individual decision making should be based on individual risk profile, on peritonitis severity score and on surgeon experience. In a two stage procedure, relevant morbidity of the second operation has to be considered. Recently suggested approaches,laparoscopic lavage or interventional drainage without resection, remain a matter of debate.