โรคถุงผนังลำไส้: การทบทวนภาพรังสีและการรักษา
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มิ.ย. 28, 2019
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บทคัดย่อ
โรคถุงผนังลำไส้ เดิมเคยเชื่อว่าเป็นโรคของคนแก่ แต่ในปัจจุบันพบได้มากขึ้นในผู้ป่วยที่อายุน้อยลง นอกจากนี้ความชุกของโรคก็เพิ่มมากขึ้นเนื่องจากประชากรมีอายุเฉลี่ยมากขึ้น ภาวะแทรกซ้อนที่พบได้บ่อยในโรคถุงผนังลำไส้คือการอักเสบ ปัจจุบันเครื่องมือทางรังสีวินิจฉัยมีความก้าวหน้ามากขึ้นทำให้การรักษาภาวะแทรกซ้อนของโรคถุงผนังลำไส้มีการเปลี่ยนแปลงใน 2-3 ปีมานี้ จึงนำมาสู่วัตถุประสงค์ของการทบทวนวรรณกรรมเรื่องโรคถุงผนังลำไส้ ข้อบ่งชี้ในแง่ของวิธีการต่างๆทางรังสีวินิจฉัย ลักษณะสำคัญที่พบของภาพรังสี และข้อมูลใหม่ๆทางการรักษาภาวะแทรกซ้อนของโรคถุงผนังลำไส้
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บทความปริทัศน์หรือการทบทวนวรรณกรรม
References
1. Klarenbeek BR, De Korte N, Van De Peet DL, Cuesta MA. Review of current classifications for diverticular disease and a transition into clinical practice. Int J Colorectal Dis. 2012; 27: 207-14.
2. Etzioni DA, Mack TM, Beart Jr RW, Kaiser AM. Diverticulitis in the United States: 1998-2005 changing patterns of disease and treatment. Ann Surg. 2009; 249: 210-7.
3. Sheiman L, Levine MS, Levin AA, Hogan J, Rubesin SE, Furth EE, et al. Chronic diverticulitis: clinical, radiographic, and pathological findings. AJR Am J Roentgenol. 2008; 191: 522-8.
4. Bahadursingh AM, Virgo KS, Kaminski DL, Longo WE. Spectrum of disease and outcome of complicated diverticular disease. Am J Surg. 2003; 186: 696-701.
5. Bianco M, Loyson A, McNinch D, Jones JS, Oosterhouse T. Obesity and acute diverticular disease: Is there an association? Ann Emerg Med. 2010; 56: S31. Available on https://dx.doi.org/10.1016/j.annemergmed.2010.06.138 access on 25/10/2016.
6. Unlu C, Daniels L, Vrouenraets BC, Boermeester MA. A systematic review of high-fibre dietary therapy in diverticular disease. Int J Colorectal Dis. 2012; 27: 419-27.
7. Koch AD, Schoon EJ. Extensive jejunal diverticulosis in a family, a matter of inheritance? Neth J Med. 2007; 65: 154-5.
8. Strate LL, Erichson R, Baron JA, Mortensen J, Pedersen JK, Riis AH, et al. Heritability and familial aggregation of diverticular disease: a population-bases study of twins and siblings. Gastroenterol. 2013; 144: 736-42.
9. Chan CC, Lo KL, Chang EC, Lo SS, Hon TY. Colonic diverticulosis in Hong Koog: distribution pattern and clinical significance. Clin Radiol. 1998; 53: 842-4.
10. De Perrot T, Poletti PA, Becker CD, Platon A. The complicated duodenal diverticulum: retrospective analysis of 11 cases. Clin Imaging. 2012; 36: 287-94.
11. Hyland R, Chalmers A. CT features of jejunal pathology. Clin Radiol. 2007; 62: 1154-62.
12. Macari M, Faust M, Liang H, Pachter HL. CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management. Clin Radiol. 2007; 62: 73-7.
13. Lin CH, Hsieh HF, Yu CY, Yu JC, Chan DC, Chen TW, Chen PJ, Liu YC. Diverticulosis of the jejunum with intestinal obstruction: A case report. World J Gastroenterol. 2005; 11: 5416–17.
14. Bulos PB. Complicated diverticulosis. Complicated diverticulosis. Best practice & Res Clin Gastroenterol. 2002; 16: 649-62.
15. Chapman JR, Dozois EJ, Wolff BG, Gullerud RE, Larson DR. Diverticulitis: a progressive disease? Do multiple recurrences predict less favorable outcomes? Ann Surg. 2006; 243: 876-83.
16. Hobson KG, Roberts PL. Etiology and pathophysiology of diverticular disease. Clin Colon Rectal SUrg. 2004; 17: 147-53.
17. Sreedharan S, Fiorentino M, Sinha S. Plain abdominal radiography in acute abdominal pain-is it necessary? Emerg Radiol. 2014; 21: 597-603.
18. RCR Working Party. Making the Best Use of a Department of Clinical Radiology: Guidelines for Doctors (fifth edition). London: The Royal College of Radiologists. 2003.
19. Greenstein S, Jones B, Fishman EK, Cameron JL, Siegelman SS. Small-bowel diverticulitis: CT findings. AJR. 1986; 147: 271-4.
20. Halligan S, Saunders B. Imaging diverticular disease. Best Practice & Research Clinical Gastroenterology. 2002; 16: 595-610.
21. Eggesbo HB, Jacobsen T, Kolmannskog E, Bay D, Nygaard K. Diagnosis of acute left-side colonic diverticulitis by three radiological modalities. Acta Radiologica. 1998; 39: 315-21.
22. Irvine EJ, O’Connor J, Frost RA, Shorvon P, Somers S, Stevenson GW, et al. Prospective comparison of double contrast barium enema plus flexible sigmoidoscopy v colonoscopy in rectal bleeding: barium enema v colonoscopy in rectal bleeding. Gut. 1988; 29: 1188-93.
23. Kenig J, Richter P, Zanowska K. Barium enema in the treatment algorithm of lower gastrointestinal tract bleeding. Polish J Surg. 2013; 85: 467-70.
24. Chou YH, Chiou HJ, Tiu CM, Chen JD, Hsu CC, Lee CH, et al. Sonography of acute right side colonic diverticulitis. Am J Surg. 2001; 181: 122-7.
25. Helou N, Abdalkader M, Abu-Rustum RS. Sonography: first-line modality in the diagnosis of acute colonic diverticulitis? J Ultras Med. 2013; 32: 1689-94.
26. Kelekis AD, poletti PA. Jejunal diverticulitis with localized perforation diagnosed by ultrasound: a case report. Eur Radiol 2002; 12: S78-81.21.
27. Beling A, Higginson AP, Mercer SJ, Cowlishaw D. Demonstration of active bleeding in a jejunal diverticulum using contrast-enhanced ultrasound. Clin Radiol 2013; 68: 100-3.
28. Yaacoub IB, Boulay-Coletta I, Julles MC, Zins M. CT findings of misleading features of colonic diverticulitis. Insights Imaging. 2011; 2: 69-84.
29. Sartelli M, Moore FA, Ansaloni L, Di Saverio S, Coccolini F, Griffths EA, et al. A proposal for a CT driven classification of left colon acute diverticulitis. World J Emerg Surg. 2015; 10: 3. Available on https://www.wjes.org/content/10/1/3. access on 25/10/2016.
30. Schreyer AG, Furst A, Agha A, Kikinis R, Scheibl K, Schoolmerich J, et al. Magnetic resonance imaging based colonography for diagnosis and assessment of diverticulosis and diverticulitis. Int J Colorectal Dis. 2004; 19: 474-80.
31. Kaewlai R, Nazinitsky KJ. Acute colonic diverticulitis in a community-based hospital: CT evaluation in 138 patients. Emerg Radiol. 2007; 13: 171-9.
32. Pereira JM, Sirlin CB, Pinto PS, Jeffrey RB, Stella DL, Casola G. Disproportionate fat stranding: a helpful sign in patients with acute abdominal pain. RadioGraphics. 2004; 24: 703-15.
33. Lips LM, Cremers PT, Pickhardt PJ, Cremers SE, Janssen-Heijnen ML, De Witte MT, et al. Sigmoid cancer versus chronic diverticular disease: differentiating features at colonography. Radiology. 2015; 275: 127-35.
34. Johnson KN, Fankhauser GT, Chapital AB, Merritt MV, Johnson DJ. Emergency management of complicated jejunal diverticulosis. Am J Surg. 2014; 80: 600-3.
35. Kubota T. Perforated jejunal diverticulitis. Am J Surg. 2007; 193: 486-7.
36. Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS, et al. American cancer society colorectal cancer advisory group, US multi-society task force, American college of radiology colon cancer committee. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from American cancer society, the US multi-society task force on colorectal cancer, and the American college of radiology. CA Cancer J Clin. 2008; 58: 130-60.
37. Hjern F, Jonas E, Holmstrom B, Josephson T, Mellgren A, Johansson C. CT colonography versus colonoscopy in the follow-up patients after diverticulitis – a prospective, comparative study. Clin Radiol. 2007; 62: 645-50.
38. Flor N, Maconi G, Sardanelli F, Lombardi MA, Colombo B, Di Leo G, et al. Prognostic value of the diverticular disease severity score based on CT colonography: follow-up in patients recovering from acute diverticulitis. Acad Radiol. 2015; 22: 1503-9.
39. Luboldt W, Bauerfeind P, Steiner P, Fried M, Krestin GP, Debatin JF. Preliminary assessment of three-dimensional magnetic resonance imgaing for various colonic disorders. The Lancet. 1997; 349: 1288-91.
40. Ajaj W, Ruehm SG, Lauenstein T, Goehde S, Kuehle C, Herborn CU, et al. Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study. Eur Radiol. 2005; 15: 2316-22.
41. Flor N, Rigamonti P, Ceretti AP, Romagnoli S, Balestra F, Sardanelli F, et al. Diverticular disease severity score based on CT colonography. Eur Radiol. 2013; 23: 2723-9.
42. Kaiser AM, Jiang JK, Lake JP, Ault G, Artinyan A, Gonzalez-Ruiz C, et al. The management of complicated diverticulitis and the role of computed tomography. Am J Gastroenterol. 2005: 100: 910-7.
43. Sarin S, Boulos PB. Long-term outcome of patients presenting with acute complications of diverticular disease. Ann R Coll Surg Engl. 1994; 76: 117-20.
44. Chautems RC, Ambrosetti P, Ludvig A, Mermillod B, Morel P, Soravia C, et al. Long-term follow-up after first acute episode of sigmoid diverticulitis: is surgery mandatory?: a prospective study of 118 patients. Dis Colon Rectum. 2002 Jul; 45: 962-6.
45. Schug-Pass C, Geers P, Hügel O, Lippert H, Kockerling F. Prospective randomized trial comparing short-term antibiotic therapy versus standard therapy for acute uncomplicated sigmoid diverticulitis. Int J Colorectal Dis. 2010; 25: 751-9.
46. Byrnes MC1, Mazuski JE. Antimicrobial therapy for acute colonic diverticulitis. Surg Infect. 2009; 10: 143-54.
47. Luigi G, Nimish V, Dino V, Alberto P, Margherita C, Giuseppe C, et al. Efficacy of 5-ASA in the treatment of colonic diverticular disease. J Clin Gastroenterol. 2010; 44: 113-9.
48. Gaertner WB, Kwaan MR, Madoff RD, Willis D, Belzer GE, Rothenberger DA, et al. The evolving role of laparoscopy in colonic diverticular disease: a systematic review. World J Surg. 2013; 37: 629-38.
49. Durmishi Y, Gervaz P, Brandt D1, Bucher P, Platon A, Morel P, et al. Results from percutaneous drainage of Hinchey stage II diverticulitis guided by computed tomography scan. Surg Endosc. 2006; 20: 1129–33.
50. Siewert B, Tye G, Kruskal J, Sosna J, Opelka F, Raptopoulos V, et al. Impact of CT-guide drainage in the treatment of diverticular abscesses: size matters. AJR Am J Roentgenol. 2006; 186: 680-686.
51. De Stigter KK, Keating DP. Imaging update: acute colonic diverticulitis. Clin Colon Rectal Surg. 2009; 22: 147-55.
52. Constantinides VA, Tekkis PP, Athanasiou T, Aziz O, Ourkayastha S, Remzi FH, 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: 966-81.
53. O’Sullivan GC, Murphy D, O’Brien MG, Ireland A. Laparoscopic management of generalized peritonitis due to perforated colonic diverticula. Am J Surg. 1996; 171: 432–34.
54. Bretagnol F, Pautrat K, Mor C, Benchellal Z, Huten N, De calan L. Emergency laparoscopic management of perforated sigmoid diverticulitis: a promising alternative to more radical procedures. J Am Coll Surg. 2008 ; 206: 654-7.
55. Taylor CJ, Layani L, Ghusn MA, White SI. Perforated diverticulitis managed by laparoscopic lavage. ANZ J Surg. 2006; 76: 962-5.
56. Karoui M, Champault A, Pautrat K, Valleur P, Cherqui D, Champault G. Laparoscopic peritoneal lavage or primary anastomosis with defunctioning stoma for Hinchey 3 complicated diverticulitis: results of a comparative study. Dis Colon Rectum. 2009; 52: 609-15.
57. Horgan AF, McConnell EJ, Wolff BG, The S, Paterson C. Atypical diverticular disease: surgical results. Dis Colon Rectum. 2001; 44: 1315-8.
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2. Etzioni DA, Mack TM, Beart Jr RW, Kaiser AM. Diverticulitis in the United States: 1998-2005 changing patterns of disease and treatment. Ann Surg. 2009; 249: 210-7.
3. Sheiman L, Levine MS, Levin AA, Hogan J, Rubesin SE, Furth EE, et al. Chronic diverticulitis: clinical, radiographic, and pathological findings. AJR Am J Roentgenol. 2008; 191: 522-8.
4. Bahadursingh AM, Virgo KS, Kaminski DL, Longo WE. Spectrum of disease and outcome of complicated diverticular disease. Am J Surg. 2003; 186: 696-701.
5. Bianco M, Loyson A, McNinch D, Jones JS, Oosterhouse T. Obesity and acute diverticular disease: Is there an association? Ann Emerg Med. 2010; 56: S31. Available on https://dx.doi.org/10.1016/j.annemergmed.2010.06.138 access on 25/10/2016.
6. Unlu C, Daniels L, Vrouenraets BC, Boermeester MA. A systematic review of high-fibre dietary therapy in diverticular disease. Int J Colorectal Dis. 2012; 27: 419-27.
7. Koch AD, Schoon EJ. Extensive jejunal diverticulosis in a family, a matter of inheritance? Neth J Med. 2007; 65: 154-5.
8. Strate LL, Erichson R, Baron JA, Mortensen J, Pedersen JK, Riis AH, et al. Heritability and familial aggregation of diverticular disease: a population-bases study of twins and siblings. Gastroenterol. 2013; 144: 736-42.
9. Chan CC, Lo KL, Chang EC, Lo SS, Hon TY. Colonic diverticulosis in Hong Koog: distribution pattern and clinical significance. Clin Radiol. 1998; 53: 842-4.
10. De Perrot T, Poletti PA, Becker CD, Platon A. The complicated duodenal diverticulum: retrospective analysis of 11 cases. Clin Imaging. 2012; 36: 287-94.
11. Hyland R, Chalmers A. CT features of jejunal pathology. Clin Radiol. 2007; 62: 1154-62.
12. Macari M, Faust M, Liang H, Pachter HL. CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management. Clin Radiol. 2007; 62: 73-7.
13. Lin CH, Hsieh HF, Yu CY, Yu JC, Chan DC, Chen TW, Chen PJ, Liu YC. Diverticulosis of the jejunum with intestinal obstruction: A case report. World J Gastroenterol. 2005; 11: 5416–17.
14. Bulos PB. Complicated diverticulosis. Complicated diverticulosis. Best practice & Res Clin Gastroenterol. 2002; 16: 649-62.
15. Chapman JR, Dozois EJ, Wolff BG, Gullerud RE, Larson DR. Diverticulitis: a progressive disease? Do multiple recurrences predict less favorable outcomes? Ann Surg. 2006; 243: 876-83.
16. Hobson KG, Roberts PL. Etiology and pathophysiology of diverticular disease. Clin Colon Rectal SUrg. 2004; 17: 147-53.
17. Sreedharan S, Fiorentino M, Sinha S. Plain abdominal radiography in acute abdominal pain-is it necessary? Emerg Radiol. 2014; 21: 597-603.
18. RCR Working Party. Making the Best Use of a Department of Clinical Radiology: Guidelines for Doctors (fifth edition). London: The Royal College of Radiologists. 2003.
19. Greenstein S, Jones B, Fishman EK, Cameron JL, Siegelman SS. Small-bowel diverticulitis: CT findings. AJR. 1986; 147: 271-4.
20. Halligan S, Saunders B. Imaging diverticular disease. Best Practice & Research Clinical Gastroenterology. 2002; 16: 595-610.
21. Eggesbo HB, Jacobsen T, Kolmannskog E, Bay D, Nygaard K. Diagnosis of acute left-side colonic diverticulitis by three radiological modalities. Acta Radiologica. 1998; 39: 315-21.
22. Irvine EJ, O’Connor J, Frost RA, Shorvon P, Somers S, Stevenson GW, et al. Prospective comparison of double contrast barium enema plus flexible sigmoidoscopy v colonoscopy in rectal bleeding: barium enema v colonoscopy in rectal bleeding. Gut. 1988; 29: 1188-93.
23. Kenig J, Richter P, Zanowska K. Barium enema in the treatment algorithm of lower gastrointestinal tract bleeding. Polish J Surg. 2013; 85: 467-70.
24. Chou YH, Chiou HJ, Tiu CM, Chen JD, Hsu CC, Lee CH, et al. Sonography of acute right side colonic diverticulitis. Am J Surg. 2001; 181: 122-7.
25. Helou N, Abdalkader M, Abu-Rustum RS. Sonography: first-line modality in the diagnosis of acute colonic diverticulitis? J Ultras Med. 2013; 32: 1689-94.
26. Kelekis AD, poletti PA. Jejunal diverticulitis with localized perforation diagnosed by ultrasound: a case report. Eur Radiol 2002; 12: S78-81.21.
27. Beling A, Higginson AP, Mercer SJ, Cowlishaw D. Demonstration of active bleeding in a jejunal diverticulum using contrast-enhanced ultrasound. Clin Radiol 2013; 68: 100-3.
28. Yaacoub IB, Boulay-Coletta I, Julles MC, Zins M. CT findings of misleading features of colonic diverticulitis. Insights Imaging. 2011; 2: 69-84.
29. Sartelli M, Moore FA, Ansaloni L, Di Saverio S, Coccolini F, Griffths EA, et al. A proposal for a CT driven classification of left colon acute diverticulitis. World J Emerg Surg. 2015; 10: 3. Available on https://www.wjes.org/content/10/1/3. access on 25/10/2016.
30. Schreyer AG, Furst A, Agha A, Kikinis R, Scheibl K, Schoolmerich J, et al. Magnetic resonance imaging based colonography for diagnosis and assessment of diverticulosis and diverticulitis. Int J Colorectal Dis. 2004; 19: 474-80.
31. Kaewlai R, Nazinitsky KJ. Acute colonic diverticulitis in a community-based hospital: CT evaluation in 138 patients. Emerg Radiol. 2007; 13: 171-9.
32. Pereira JM, Sirlin CB, Pinto PS, Jeffrey RB, Stella DL, Casola G. Disproportionate fat stranding: a helpful sign in patients with acute abdominal pain. RadioGraphics. 2004; 24: 703-15.
33. Lips LM, Cremers PT, Pickhardt PJ, Cremers SE, Janssen-Heijnen ML, De Witte MT, et al. Sigmoid cancer versus chronic diverticular disease: differentiating features at colonography. Radiology. 2015; 275: 127-35.
34. Johnson KN, Fankhauser GT, Chapital AB, Merritt MV, Johnson DJ. Emergency management of complicated jejunal diverticulosis. Am J Surg. 2014; 80: 600-3.
35. Kubota T. Perforated jejunal diverticulitis. Am J Surg. 2007; 193: 486-7.
36. Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS, et al. American cancer society colorectal cancer advisory group, US multi-society task force, American college of radiology colon cancer committee. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from American cancer society, the US multi-society task force on colorectal cancer, and the American college of radiology. CA Cancer J Clin. 2008; 58: 130-60.
37. Hjern F, Jonas E, Holmstrom B, Josephson T, Mellgren A, Johansson C. CT colonography versus colonoscopy in the follow-up patients after diverticulitis – a prospective, comparative study. Clin Radiol. 2007; 62: 645-50.
38. Flor N, Maconi G, Sardanelli F, Lombardi MA, Colombo B, Di Leo G, et al. Prognostic value of the diverticular disease severity score based on CT colonography: follow-up in patients recovering from acute diverticulitis. Acad Radiol. 2015; 22: 1503-9.
39. Luboldt W, Bauerfeind P, Steiner P, Fried M, Krestin GP, Debatin JF. Preliminary assessment of three-dimensional magnetic resonance imgaing for various colonic disorders. The Lancet. 1997; 349: 1288-91.
40. Ajaj W, Ruehm SG, Lauenstein T, Goehde S, Kuehle C, Herborn CU, et al. Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study. Eur Radiol. 2005; 15: 2316-22.
41. Flor N, Rigamonti P, Ceretti AP, Romagnoli S, Balestra F, Sardanelli F, et al. Diverticular disease severity score based on CT colonography. Eur Radiol. 2013; 23: 2723-9.
42. Kaiser AM, Jiang JK, Lake JP, Ault G, Artinyan A, Gonzalez-Ruiz C, et al. The management of complicated diverticulitis and the role of computed tomography. Am J Gastroenterol. 2005: 100: 910-7.
43. Sarin S, Boulos PB. Long-term outcome of patients presenting with acute complications of diverticular disease. Ann R Coll Surg Engl. 1994; 76: 117-20.
44. Chautems RC, Ambrosetti P, Ludvig A, Mermillod B, Morel P, Soravia C, et al. Long-term follow-up after first acute episode of sigmoid diverticulitis: is surgery mandatory?: a prospective study of 118 patients. Dis Colon Rectum. 2002 Jul; 45: 962-6.
45. Schug-Pass C, Geers P, Hügel O, Lippert H, Kockerling F. Prospective randomized trial comparing short-term antibiotic therapy versus standard therapy for acute uncomplicated sigmoid diverticulitis. Int J Colorectal Dis. 2010; 25: 751-9.
46. Byrnes MC1, Mazuski JE. Antimicrobial therapy for acute colonic diverticulitis. Surg Infect. 2009; 10: 143-54.
47. Luigi G, Nimish V, Dino V, Alberto P, Margherita C, Giuseppe C, et al. Efficacy of 5-ASA in the treatment of colonic diverticular disease. J Clin Gastroenterol. 2010; 44: 113-9.
48. Gaertner WB, Kwaan MR, Madoff RD, Willis D, Belzer GE, Rothenberger DA, et al. The evolving role of laparoscopy in colonic diverticular disease: a systematic review. World J Surg. 2013; 37: 629-38.
49. Durmishi Y, Gervaz P, Brandt D1, Bucher P, Platon A, Morel P, et al. Results from percutaneous drainage of Hinchey stage II diverticulitis guided by computed tomography scan. Surg Endosc. 2006; 20: 1129–33.
50. Siewert B, Tye G, Kruskal J, Sosna J, Opelka F, Raptopoulos V, et al. Impact of CT-guide drainage in the treatment of diverticular abscesses: size matters. AJR Am J Roentgenol. 2006; 186: 680-686.
51. De Stigter KK, Keating DP. Imaging update: acute colonic diverticulitis. Clin Colon Rectal Surg. 2009; 22: 147-55.
52. Constantinides VA, Tekkis PP, Athanasiou T, Aziz O, Ourkayastha S, Remzi FH, 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: 966-81.
53. O’Sullivan GC, Murphy D, O’Brien MG, Ireland A. Laparoscopic management of generalized peritonitis due to perforated colonic diverticula. Am J Surg. 1996; 171: 432–34.
54. Bretagnol F, Pautrat K, Mor C, Benchellal Z, Huten N, De calan L. Emergency laparoscopic management of perforated sigmoid diverticulitis: a promising alternative to more radical procedures. J Am Coll Surg. 2008 ; 206: 654-7.
55. Taylor CJ, Layani L, Ghusn MA, White SI. Perforated diverticulitis managed by laparoscopic lavage. ANZ J Surg. 2006; 76: 962-5.
56. Karoui M, Champault A, Pautrat K, Valleur P, Cherqui D, Champault G. Laparoscopic peritoneal lavage or primary anastomosis with defunctioning stoma for Hinchey 3 complicated diverticulitis: results of a comparative study. Dis Colon Rectum. 2009; 52: 609-15.
57. Horgan AF, McConnell EJ, Wolff BG, The S, Paterson C. Atypical diverticular disease: surgical results. Dis Colon Rectum. 2001; 44: 1315-8.
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