An 80-year-old woman comes to the emergency room with abdominal pain starting in the epigastrium and radiating later to the left iliac fossa. An abdominal CT scan is performed, showing inflammation in the walls of the sigma and mesenteric abscess of 2 cm. The treatment of choice is:
We are asked about the management of a very common pathology, diverticulitis. And we are asked about the different therapeutic options depending on how advanced it is. The correct answer is 1, it does not meet the criteria to require drainage by guided puncture (the abscess is not larger than 5-6 cm). Discharge colostomy in this case makes no sense whatsoever, since it is not a question of solving an obstructive condition. Drainage by laparoscopic surgery is not indicated in this case. It could be indicated in the absence of the possibility of percutaneous drainage after failure of conservative treatment, although it is a very controversial option at this time. Sigmoidectomy and anastomosis is also not required. In a high number of cases, after the resolution of the symptoms, the outbreaks are reduced and they can be prevented with diet and hygienic dietary habits.
Admission to the ward with absolute diet and broad-spectrum antibiotic treatment.
Discharge colostomy.
Drainage by laparoscopic surgery.
Urgent surgery with sigmoidectomy and colorectal anastomosis.
In a high number of cases, after the resolution of the symptoms, the outbreaks are reduced and they can be prevented with diet and hygienic dietary habits.
Discharge colostomy in this case makes no sense whatsoever, since it is not a question of solving an obstructive condition.
it does not meet the criteria to require drainage by guided puncture (the abscess is not larger than 5-6 cm).
Sigmoidectomy and anastomosis is also not required.