Keywords
Surgery
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Abstract
Objective: To understand the main changes in the surgical approach to acute diverticulitis. Bibliographic review: Acute diverticulitis is the result of perforation of the wall of the diverticulum in diverticular disease, occurring in 10 to 25% of patients with diverticulosis, The suspicion is usually clinical, with a well-defined symptomatological picture. However, the clinical picture alone does not confirm the diagnosis, requiring investigation with imaging tests, such as computed tomography, and laboratory tests, such as leukogram. Acute diverticulitis should be analyzed according to the Hinchey classification, considering Hinchey III and IV as indicative of surgical management. The new surgical technique of primary anastomosis has been replacing the need to use the Hartmann procedure, which was the most used, reserving this procedure for selected cases. Final considerations: It was observed that the surgical approach to acute diverticulitis has undergone advances in recent years, with the emergence of the primary anastomosis technique, presenting pros and cons in relation to the Hartmann procedure, in addition to new options for using laparoscopic lavage and of damage control surgery to reduce the need for stoma formation and management of diffuse peritonitis, respectively.
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