FOCUS ON – Guidelines SICCR – Colonic Diverticular Disease (commented by Mario Pescatori)

Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines
Binda GA, Cuomo R, Laghi A, Nascimbeni R, Serventi A, Bellini D, Gervaz P, Annibale B.
Tech Coloproctol. 2015 Oct;19(10):615-26. doi: 10.1007/s10151-015-1370-x. Epub 2015 Sep 16. PMID: 26377584

As the Guidelines are clearly exposed in the article, rather than commenting them I prefer to give an example aimed at demonstrating how the work done by this group of authors (and by the others) may be useful, not only for the clinical practice, but also to solve controversies in case of litigation. A month ago, a surgeon was accused of malpractice, as he did not perform an emergency operation in a 60 yrs old male patient who already had a previous episode of acute diverticulitis and had been admitted in his hospital with severe crampy abdominal pain. The patient was stable, the TC scan did not show any peritoneal involvement and he had a bowel motion after few hours. At 8 p.m. the surgeon, who was on call, went home. At 11 p.m. the patient was operated by another surgeon, who found a pericolic abscess and carried out a sigmoidectomy with a Hartmann procedure. The postoperative course was uneventful and the patient was discharged after a week. The accused surgeon asked for the help of four expert colorectal surgeons, who then wrote reports in his favour, based on the SICCR Guidelines. Having red them, the judge decided that he was not guilty.