DIVERTICULOSIS of the colon is an irreversible structural change that occurs in approximately 5% of persons beyond middle age. Symptoms are absent or inconsequential unless some degree of inflammation supervenes; this constitutes diverticulitis and occurs in an estimated 10% of diverticulosis cases.1 In the great majority of these cases diet and medication constitute adequate treatment, but complications requiring surgery occur in approximately 1 in every 10 cases of diverticulitis. Such complications are perforation, abscess, fistula formation, obstruction, hemorrhage, and inability to differentiate between diverticulitis and cancer.
The current surgical trend is not toward new procedures in the treatment of these complications, for the fundamental operations have been long established. But modern bowel surgery has been rendered less hazardous by the development of poorly absorbed sulfonamides and antibiotics so that a more radical approach to the problem may decrease the over-all morbidity of the disease without an unreasonable mortality rate.