0:01

Alrigh. So that case of diverticulitis with perforation

0:03

would be a fantastic case for our interventional

0:07

folks, and that's what they're all about.

0:09

So this is the patient's status post-drainage,

0:11

where you can see the pigtail catheter

0:12

going into what was the cavity and abscess,

0:15

and has now been sufficiently drained.

0:17

We manage a lot of tubes and drains in our hospital,

0:20

uh, our interventional team

0:21

is very aggressive with that.

0:23

This one is seen through the anterior abdomen.

0:24

I'll tell you, a lot of times you'll come back

0:26

and the patients will have had a posterior drain.

0:28

A lot of our drains for the deeper pelvic structures

0:30

nicely can be drained posteriorly with the

0:32

catheter seated through the piriformis muscle here.

0:35

That gives a nice chunky hold on the

0:37

catheter so they don't come out as easily,

0:40

depending on if the patient has a

0:41

significant pannus, that can cause some

0:43

torsion of the catheter.

0:45

So you can see anterior or posterior approaches

0:47

depending on the patient's habitus and what will

0:50

um, be a better access for those large abscesses.

0:55

Here we have another case, which is diverticulitis

0:58

with what's called a micro-perforation.

1:00

So here we see just tiny locules of air adjacent to

1:03

this segment of diverticulitis where there's a lot

1:05

of wall thickening and some small little diverticula.

1:08

And this is micro-perforation.

1:09

We see a lot of micro-perforations.

1:11

They're basically just a contained perforation.

1:13

They're usually within the

1:15

pericolonic fat of the mesocolon.

1:17

They're treated conservatively,

1:19

which is antibiotic treatment.

1:21

Sometimes the air will actually come all the

1:23

way along the IMV, but our surgeons will still

1:25

consider those to be contained and will treat

1:29

them conservatively, allowing the patient

1:31

to have a lower intervention threshold.

Diverticulitis: Perforated With Abscess Post Drainage

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