Laparoscopic lavage is seen as an acceptable alternative to colonic resection in selected patients with acute diverticulitis with purulent peritonitis. There is no consensus on what surgical technique should be used when performing this procedure. This case series describes the disease course of 3 patients with acute diverticulitis with purulent peritonitis treated with laparoscopic lavage and direct suturing of a colonic perforation. All patients (38- and 71-year-old males and a 44-year-old female) were seen in the emergency department due to acute lower abdominal pain. Clinical examination and laboratory and imaging studies were suggestive of perforated diverticular disease. Laparoscopic lavage with placement of drain(s) and direct suturing of a colonic perforation was performed. Postoperative treatment with intravenous antibiotics was continued for a variable term. Postoperative courses were uneventful. Patients were discharged on postoperative days 5, 5, and 7. At almost 1-year follow-up, all patients are in good clinical condition and have not had a recurrent episode of diverticulitis. Therefore, this case series shows promising results of laparoscopic lavage with direct suturing of colonic perforation in patients with diverticulitis with perforation and purulent peritonitis.
Case Rep Gastroenterol 2021;15:765–771

中文翻译：

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腹腔镜灌洗治疗并发结肠穿孔的复杂性憩室炎，总是关闭？

对于特定的急性憩室炎伴化脓性腹膜炎患者，腹腔镜灌洗被视为结肠切除术的可接受替代方案。在执行此程序时应使用何种手术技术尚未达成共识。本病例系列描述了 3 例急性憩室炎伴化脓性腹膜炎患者，采用腹腔镜灌洗和结肠穿孔直接缝合治疗的病程。所有患者（38 岁和 71 岁男性和 44 岁女性）均因急性下腹痛在急诊科就诊。临床检查和实验室及影像学研究提示有穿孔性憩室病。进行腹腔镜灌洗，放置引流管并直接缝合结肠穿孔。静脉注射抗生素的术后治疗持续了一个可变的期限。术后课程平静。患者在术后第 5、5 和 7 天出院。在近 1 年的随访中，所有患者的临床状况良好，没有憩室炎复发. 因此，本病例系列显示了腹腔镜灌洗联合结肠穿孔直接缝合治疗憩室炎穿孔和化脓性腹膜炎患者的可喜结果。
Case Rep Gastroenterol 2021；15:765–771