Sutures and Wound Repair/ General Surgery (ABSA) Practice Test

What is the typical procedure performed after resection of a perforated diverticulum of the colon?

1. Single stage operation

2. Two stage operation

3. Immediate colostomy

4. End-to-end anastomosis

The correct answer is: Two stage operation

After resection of a perforated diverticulum of the colon, the typical procedure is a two-stage operation. In cases of perforated diverticulitis, especially when there is significant inflammation, resection may be followed by creating a colostomy. This allows the affected area of the colon to heal while diverting stool away from the repair site, minimizing the risk of contamination and complications such as leakage. In the first stage, the diseased section of the colon is removed, and a colostomy is performed. Typically, a limited resection is done due to the inflammatory process that may render the surrounding tissues friable and prone to complications. After adequate healing, which may take a few months, a second-stage operation can be scheduled to reverse the colostomy and perform an anastomosis, restoring normal bowel continuity. This approach allows for better management of the infection and surrounding tissue integrity, increasing the likelihood of a successful outcome upon restoration of bowel continuity in the later stages.