Abstract

Introduction. Diverticulosis of the colon is one of the most common diseases of the intestine. In recent years, there has been an increasing tendency for diverticular disease (DD) to manifest itself at earlier age, as well as to the more frequent development of complications in young and middle - aged people. Most interventions for planned surgical treatment of DD complications are performed by two - stage access for laparotomy. One - stage laparoscopic intervention is a relatively new approach to treatment. Case report. 40-year - old man was hospitalized in the surgical department with complaints of air release during urination and aching pain in the lower part of abdomen. Outpatient examination excluded the pathology of the prostate gland and revealed infiltration between the urinary bladder and sigmoid colon. A complex examination, including cystoscopy, colonoscopy, multispiral computed tomography with contrast, showed the presence of chronic paracolic infiltration and blad - derntestinal fistula, which complicated the latent course of colon DD. Laparoscopic opening the abscess, resection of the sigmoid colon, the formation of descendo - rectal anastomosis was performed in one - step. Intra - and postoperative complications were not observed, dynamic observation and control examination after 6 months showed no symptoms. Discussion. One - stage laparoscopic surgery in the treatment of chronic inflammatory complications of colon DD is currently available procedure, which allows in a short time to relieve patients from symptoms and has good immediate and long - term results. The condition for the use of this technique is a sufficient experience of laparoscopic surgery of the abdominal cavity, retroperitoneal space and pelvis.

Highlights

  • Diverticulosis of the colon is one of the most common diseases of the intestine

  • Most interventions for planned surgical treatment of diverticular disease (DD) complications are performed by two-stage access for laparotomy

  • 40-year-old man was hospitalized in the surgical department with complaints

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Summary

Introduction

Diverticulosis of the colon is one of the most common diseases of the intestine. In recent years, there has been an increasing tendency for diverticular disease (DD) to manifest itself at earlier age, as well as to the more frequent development of complications in young and middle-aged people. При распространении воспалительного процесса с дивертикула на брыжейку сигмовидной ободочной кишки, большой сальник, тонкую кишку и органы малого таза происходит формирование паракишечного инфильтрата, который при отсутствии своевременного лечения приводит к формированию хронических воспалительных осложнений, в том числе свищей, частота образования которых составляет от 4 до 20% [1]. У молодых отмечено более агрессивное течение заболевания, пятикратное увеличение риска развития осложнений, таких как образование свищей, что требует большего объема хирургического вмешательства, чем у пожилых пациентов [6].

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