PAEA Surgery End Of Rotation (EOR) Practice Exam

After two hospitalizations due to diverticulitis, what is recommended?

1. Regular follow-up visits

2. Emergency surgery

3. Elective sigmoid colectomy

4. Increased dietary fiber

The correct answer is: Elective sigmoid colectomy

When a patient experiences recurrent episodes of diverticulitis, the recommendation often shifts towards an elective surgical intervention, such as a sigmoid colectomy. This approach is typically indicated after multiple hospitalizations for the condition because recurrent diverticulitis can lead to more serious complications, like perforation, abscess formation, or chronic bowel obstruction. The rationale for opting for an elective sigmoid colectomy involves a few key considerations. Firstly, surgery can help reduce the frequency of diverticulitis attacks, thereby decreasing the risk of subsequent hospitalizations and complications. The sigmoid colon is commonly affected in diverticulitis, and removing it can provide a definitive solution to the problem, especially in patients who do not respond well to conservative management. While regular follow-up visits and increased dietary fiber intake can be part of the management plan for diverticular disease and may enhance the care of patients with diverticulitis, they are generally not viewed as sufficient when a patient has experienced multiple acute episodes requiring hospitalization. Emergency surgery may be required in acute scenarios of severe diverticulitis, but in a case where a patient has had repeated episodes, elective surgery is the proactive management strategy recommended.