The Current Surgical Management of Complicated Left-Sided Colonic Diverticulitis: Narrative Review Article

Kumar Hari Rajah

doi:10.64387/tjs.2026.276432

Authors

Kumar Hari Rajah Taylor's University School of Medicine and Health Science, Selangor https://orcid.org/0000-0001-8424-2936

DOI:

https://doi.org/10.64387/tjs.2026.276432

Keywords:

Colonic diverticulitis, Hinchey classification, Laparoscopic lavage, Hartmann’s procedure, Sigmoid colectomy, Sigmoid diverticulitis, Open surgery

Abstract

Acute left-sided diverticulitis represents the most prevalent form of acute diverticulitis and is categorized into two types: complicated and uncomplicated. The surgical intervention for complicated diverticulitis is classified into the Hartmann’s procedure or sigmoid resection with anastomosis, accompanied by a protective ileostomy. Damage control surgery is indicated for patients with complicated left-sided diverticulitis who are hemodynamically unstable. Laparoscopic lavage serves as a bridging procedure in cases of complicated diverticulitis with purulent discharge or classified as Hinchy 3, aiming to stabilize the patient for subsequent definitive surgery. This review will examine the surgical management of complicated left-sided diverticulitis, with a focus on Hartmann’s procedure and colonic resection with anastomosis. Additionally, we will explore the role of laparoscopic lavage in the context of complicated diverticulitis.

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