When is surgery for diverticulitis considered?

When is surgery for diverticulitis considered?

Surgery for diverticulitis is considered if you have:

• Abscesses: An abscess is a contained or “walled-off” infection in the abdomen. If the fluid in an abscess (a collection of bacteria and white blood cells) is not successfully drained with a needle or catheter, surgery is needed. In surgery, the abscess is cleaned up and the affected part of the colon is removed.
• Perforation/peritonitis: A tear (perforation) in your colon allows pus or stool to leak into your abdominal cavity, resulting in peritonitis. This is a life-threatening infection that requires emergency surgery to clean the cavity and remove the damaged part of the colon.
• Blockages or strictures: Previous infections in your colon can cause scars to form, which can result in a partial or complete blockage or strictures (narrowing of sections of the colon). A complete blockage requires surgery (partial blockage does not).
• Fistulas: A fistula is an abnormal passageway or tunnel that forms and connects with another organ. An abscess that erodes into the surrounding tissue creates these passageways. A fistula in the colon can connect to the skin, bladder, vagina, uterus or another part of the colon. Most fistulas don’t close on their own so surgery is needed.
• Continued rectal bleeding (also called diverticular bleeding): Diverticular bleeding occurs when a small blood vessel near the diverticula bursts. Mild bleeding usually stops on its own, but about 20% of cases require treatment. Surgery may be needed if other attempts to stop the bleeding fail, such as clipping, drug infusion or cauterizing the bleeding artery. If bleeding is heavy and rapid, emergency surgery is a needed.
• Severe diverticulitis that has not responded to other treatment methods.
• Multiple attacks despite following a high-fiber diet. You and your surgeon may decide surgery to remove the diseased part of the colon is the best method to prevent future attacks.