ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ BIẾN CHỨNG THỦNG DO VIÊM TÚI THỪA ĐẠI TRÀNG TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

Objectives: The results of treatment of complications of perforated colonic diverticulitis at Viet Duc Friendly Hospital from 2018 to 2022. Method: Cross-sectional retrospective description of all patients diagnosed with perforation complications due to colonic diverticulitis and treatment at Viet Duc Friendly Hospital from January 2018 to December 2022. Results: Includes 54 patients (15 female and 39 male), the mean age was 60.14 ± 14.7 years old, symtoms include abdominal pain (92.6%), fever (44%), shock (7,4%). The majority of diverticulitis perforation sites are located in the left colon (64.8%), and the right colon accounts for 35.2% on computed tomography. Classification of lesion images according to Hinchey classification stage Ib, II, III, IV are 22.2%, 44.4%, 26%,7.4%. 51.8% of patients received medical treatment, of which 17.9% of patients received a combination of antibiotics and abscess drainage. 48.2% of patients had surgery, of which 73.1% had indications for emergency surgery according to Hinchey stage II, III, IV, 5.3%, 73.7%,21%; indications for surgery of the left colon were the majority (80.8%), while 19.2% were for the right colon, 17 patients had the Hartmann‘s procedure (65.4%), 7 patients had the surgery sessions (26.9%) were all stage II and had primary anastomosis. Treatment time according to the Hinchey classification was 10.5 ± 5.6 days for stage Ib, 12 ± 6.8 days for stage II medical treatment, 10 ± 3 days for stage II surgical treatment, 13 9 ± 6.5 days for stage III, 20.25 ± 8.8 days for stage IV. The rate of patients with postoperative wound infection was 50%. Conclusion: Colon diverticulitis complicated by perforation is common in middle-aged people, with a male predominance. Common clinical symptoms are abdominal pain, fever and shock. Diagnosis is mainly based on computed tomography and right diverticulum perforation has a better prognosis than the left; the rate of Hinchey stages III and IV is still high. Therefore, we need to evaluate well the stage of perforated diverticulitis to have a timely and appropriate treatment strategy for each patient.