A 44-year-old woman has had two hospitalised episodes of uncomplicated acute sigmoid diverticulitis within 18 months, both managed conservatively. She has now fully recovered and colonoscopy is normal apart from diverticula. As per standard surgical teaching followed in Indian examinations, what is recommended?
- A Elective sigmoid colectomy after recovery from the second attack ✓
- B High-fibre diet alone, surgery only after a third attack
- C Lifelong rifaximin prophylaxis
- D Emergency Hartmann's procedure now
Correct answer: A. Elective sigmoid colectomy after recovery from the second attack
Explanation
Traditional teaching, still the convention in Indian postgraduate examinations, advises elective sigmoid colectomy after two documented attacks of diverticulitis, since each subsequent attack carries higher risk of perforation and emergency surgery. Note that recent Western guidelines have moved toward individualised decisions based on severity and immunosuppression, but for exam purposes the two-attack threshold remains the expected answer. Rifaximin is not proven prophylaxis against recurrence requiring surgery.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.