A scientific review on the topic "Diverticular disease of the colon" is presented. The study provides a definition of diverticulum, diverticulosis and diverticulitis of the colon. The prevalence and incidence of the disease among different age and ethnic groups in developed and developing countries is shown. The etiology and pathogenesis of the disease is revealed taking into account the views of different researchers. Various methods of treatment, both the disease itself and its complications are viewed. Several treatment variants are shown, using traditional and recent techniques with corresponding results.

From 2011 to 2015, in the Alexander hospital, enrolled 656 patients with diverticular disease of the colon. 23 (3.5%) people were admitted as planned, in an emergency 633 (96.5%). Diverticulitis was detected in 504 (79.6%) patients. Of these, 124 (24.6%) were operated on urgently. Primary laparoscopy was performed in 73 (58.9%) patients, 24 (32.9%) of them were operated on in a delayed manner. 380 (75.4%) patients received conservative therapy, 16 of them (4.2%) after relief of acute diverticulitis were also operated on in a delayed manner. 23 patients were operated on as planned for diverticular colon disease. During the study, two equal groups of patients were formed. The results of treatment of patients with delayed surgical interventions (n=40) and planned operations (n=23) were compared. The duration of treatment, the frequency of complications and the number of observations were analyzed, when it was possible to complete a radical treatment without colostomy. According to the results of the study, we concluded that the implementation of delayed operations in diverticulitis of the colon allows to perform radical treatment during one hospitalization. At the same time, the results of delayed interventions are comparable to the results of planned operations with uncomplicated diverticulosis.

This study presented examination and treatment results of 129 patients with bleeding from the lower gastrointestinal tract who were treated at the Alexandrovskaya Hospital of St. Petersburg in the period from 2012 to 2017. Examination and treatment were performed in the intensive care unit following current clinical guidelines, taking into account the identified concomitant diseases. Endoscopic examination of the colon is the main diagnostic method for the pathological processes that caused bleeding from the lower gastrointestinal tract. Conservative therapy has been demonstrated effectiveness, and urgent surgical treatment was not needed. The main drug therapy included antifibrinolytic drugs and fresh-frozen plasma preparations. Continuous parenteral administration of proteolysis inhibitors was mandatory. Intensive therapy included correction of hemodynamic disturbances and respiratory failure and restoration of the volume of the circulating blood and plasma. Such an approach was found to be 90% effective. In patients with diverticular disease, bleeding from the colonic diverticula develops in one-third of cases. However, if additional risk factors are present, their frequency reaches 50%, often causing death. Continuous or recurrent bleeding is an indication of surgery. In our study, the conservative method of stopping bleeding from the colonic diverticula was possible in all cases. In general, the disease correlated with the age of the patients. In 68 (53%) patients, bleeding occurred despite anticoagulant or antiplatelet therapy. Patients with bleeding from colonic diverticula do not require urgent surgical intervention, and these patients may require admission to the intensive care unit. Intensive care should include the provision of antifibrinolytic drugs, proteolysis inhibitors, and fresh-frozen plasma.