重度未分解性憩室炎并发S型和膀胱1例

                               
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53 y/o male patient with an episode of acute diverticulitis Hinchey Ib and stenosis of the sigmoid colon treated with repeated cycles of antibiotics at another institution

After 4 weeks presented at ED with un-resolving acute diverticulitis despite ongoing antibiotics, severe sepsis with fever (39 °C), abdominal pain, CT scan showing partial obstruction of the Large Bowel as well as of the Small Bowel with a distal ileal loop and the appendix being strictly adherent and stuck to the inflamed sigmoid, an unresolved small pericolic abscess (H 1b) and suspicion of infiltration vs fistula with the urinary bladder
Diagnosis: Unresolving persistent acute diverticultis stage Ib vs IIb with partial BO
Planned Urgent diagnostic laparoscopic + Proceed


Laparoscopic sigmoidectomy, with separation of the distal ileum & bladder, appendectomy, primary colorectal anastomosis

Video #1

Operating Surgeon: Dr. Salomone Di Saverio MD FACS FRCS