EC Clinical and Medical Case Reports

The management of acute diverticulitis with perforation is often immediate surgical intervention. In this case we discuss the management of perforated sigmoid diverticulitis and abscess without surgical intervention. The patient is a 77-year-old male with a history of diverticulosis and recurrent acute diverticulitis that developed an acute sigmoid diverticulitis with perforation. While deferring to patient’s choice and decision, he has been managed conservatively with serial interval imaging studies and antibiotics both as outpatient and inpatient, with satisfactory outcome. He still has episodic acute presentations, but has remained fairly stable over a three and half year period.

This case report highlights the successful non-surgical approach to management of perforated sigmoid diverticulitis. While the patient’s outcome was favorable and he is pleased with the resolution of his illness, this case demonstrates the pros and cons of non-surgical management of perforated diverticulitis. It also emphasizes the role of the patient’s autonomy and decision-making in their health care.

 Keywords: Perforation; Surgical Intervention; Acute Sigmoid Diverticulitis

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