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[Comment] Laparoscopic peritoneal lavage for perforated diverticulitis: in search of evidence

15 years ago, recommendations for management of acute sigmoid diverticulitis were well established.1 Patients with uncomplicated diverticulitis (no evidence of perforation, abscess, fistula, or stricture) were managed with antibiotics and bowel rest. In the event of disease recurrence, patients were scheduled for an elective colectomy on the basis of the belief that further recurrence would increase the risk of sepsis and the need for colostomy. By contrast, patients with complicated diverticulitis were managed definitively with sigmoidectomy—often including an ostomy.

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