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Vol. 70. Núm. 5.
Páginas 253-260 (Noviembre 2001)
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Vol. 70. Núm. 5.
Páginas 253-260 (Noviembre 2001)
DOI: 10.1016/S0009-739X(01)71893-3
Acceso a texto completo
Enfermedad diverticular: revisión histórica y estado actual
Diverticular disease: Historical review and current situation
Visitas
...
M. Rodríguez
,1
Autor para correspondencia
marobla@terra.es

Correspondencia: Dr. M. Rodríguez. Servicio de Cirugía General y Digestiva. Hospital de la Santa Creu i Sant Pau. Sant Antoni Maria Claret, 167. 08025 Barcelona.
, V. Artigas*, M. Trías*, J.V. Roig**, R. Belda***
* Servicios de Cirugía General y Digestiva. Hospital de la Santa Creu i Sant Pau. Barcelona
** Hospital de Sagunto
*** Hospital de Torrecárdenas
Información del artículo
Resumen
Bibliografía
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Estadísticas
Resumen
Introducción

La enfermedad diverticular del colon presenta una incidencia elevada en los países occidentales. El presente trabajo se propone llevar a cabo tanto una revisión histórica como del estado actual de las actuaciones diagnósticas y del tratamiento en sus diferentes estadios.

Material y métodos

Para la revisión bibliográfica se ha recurrido a la búsqueda a través de Medline de las publicaciones previas.

Resultados y conclusión

La enfermedad diverticular presenta una clara relación con la dieta pobre en fibra. En el diagnóstico de diverticulitis aguda no deben emplearse métodos invasivos (enema opaco, fibrocolonoscopia) por el riesgo de complicaciones que conllevan, siendo preferible los métodos de imagen (tomografía axial computarizada; ecografía abdominal). El enema opaco y la fibrocolonoscopia son útiles en el estudio de la enfermedad en fase no aguda y para el diagnóstico diferencial. El tratamiento de la diverticulitis aguda no complicada es médico en los primeros episodios y quirúrgico en los casos recidivantes, siendo preferible la cirugía programada en un solo tiempo. Los abscesos abdominales pueden tratarse mediante punción guiada por ecografía o TAC, permitiendo así realizar la cirugía en un segundo tiempo, cuando ha remitido la fase aguda. La cirugía laparoscópica puede suponer una vía de abordaje en el tratamiento de la diverticulitis aguda no complicada.

Palabras clave:
Diverticulitis
Colon
Enfermedad diverticular
Palabras clave:
Diverticulitis
Colon
Diverticular disease
Introduction

Diverticular disease of the colon is very frequent in the occidental countries. In this paper we review the diagnosis and treatment in different stages of the disease.

Material and methods

We performed a sistematic review of the Medline data base.

Results and conclusions

Diverticular disease is related to poor fibre diet. Aggressive methods of diagnosis should not be used in the management due to the increased risk of complications. CT and ultrasonography should be prefered. However, colonoscopy and barium enema is the best diagnostic method in not acute cases. The treatment of diverticular disease should be preferably medical. But surgery may be necessary in acute relapsing cases. Abdominal absess should be treated by percutaneous drainage, and elective surgery performed in a elective phase. The laparoscopic approach in non complicated case is promising.

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