대한대장항문학회

Purpose : Diverticular disease of the colon is relatively common in western population and<br>rare in oriental population but in recent years the incidence is steadily increasing in oriental<br>population including Korean, so more concerns and appropriate management are required.<br>Methods : We reviewed 111cases who had diverticular disease in the colon from January 1988<br>to May 1998 in the Soonchunhyang University Chunan Hospital. Of 111 cases, 87 cases were<br>treated conservatively and 24 cases received a surgical treatment. Results : The annual<br>incidence increased progressively for the last 10 years. The mean age of the patients at the<br>time of diagnosis was 49.6 years and the most common age-group was forth decades (25%).<br>The diverticula were located in the right colon 89%, left colon 7% and both side 4%. Among<br>24 surgically treated cases, the most common preoperative diagnosis was acute appendicitis<br>(75%) and the correct preoperative diagnosis was made only 3 cases (13%) who had previous<br>appendectomy history, previous diagnosed history or received barium enema due to recurrent<br>pain attack. The surgical procedures of the colonic diverticulosis were right hemicolectomy (6<br>cases), ileo-ascending colectomy (6 cases), diverticulectomy (2 cases), segmental resection of<br>transverse colon (1 case), left hemicolectomy (1 case), appendectomy (2 cases), appendectomy<br>with drainage (3 cases), appendectomy with drainage and diverticulectomy (3 cases). The<br>postoperative complication was wound infection in all complicated cases. There was no<br>postoperative mortality. Conclusions : The outcome of patients in our series is satisfactory<br>despite of diagnostic inaccuracies. Preoperative barium study is recommended in those above<br>the 40 years of age suspected the appendicitis. We recommend surgery for patients after two<br>or three episodes of acute diverticulitis that resolves after medical treatment with antibiotics.<br>