DIVERTICULITIS AND MYOCARDIAL REVASCULARIZATION: SURGICAL MANAGEMENT OF PATIENTS WITH DIVERTICULITIS AND CORONARY ARTERY DISEASE

Abstract

Introduction: Diverticulitis is an inflammatory condition of diverticula, sac-like structures that form in the walls of the colon. Its manifestations can range from mild to severe complications, such as intestinal perforation and peritonitis. On the other hand, coronary artery disease (CAD) is characterized by obstruction of the coronary arteries, which can lead to myocardial infarction and heart failure. The management of patients with both diverticulitis and coronary artery disease is challenging, as it involves complex therapeutic decisions, which include both the treatment of diverticulitis and myocardial revascularization, when indicated. Objective: To analyze the surgical approaches of patients with concomitant diverticulitis and coronary artery disease, evaluating the implications of clinical and surgical management and the results obtained. Methodology: The methodology used followed the PRISMA checklist, searching for scientific articles published in the last 10 years in the PubMed, Scielo and Web of Science databases. The descriptors "diverticulitis", "coronary artery disease", "myocardial revascularization", "surgical management" and "combined treatment" were used. Studies that addressed the occurrence of diverticulitis and CAD and the surgical approach in patients with both conditions were included. Exclusively, articles that addressed only one of the diseases in isolation, case studies and research with imprecise data were discarded. Results: The main results showed that the surgical management of patients with diverticulitis and coronary artery disease requires careful assessment of surgical risk. Myocardial revascularization can be performed in conjunction with colon resection surgery, but the choice of the type of surgery (open or minimally invasive) depends on the patient's clinical presentation and comorbidities. In many cases, the combined approach has shown good results, with control of both diverticulitis and CAD, but with increased risks of postoperative complications. Conclusion: Surgical treatment of patients with diverticulitis and coronary artery disease requires strategic planning that takes into account both cardiac and gastrointestinal aspects. A multidisciplinary approach is essential to optimize results and minimize complications. The available literature suggests that, although challenging, the combined surgical approach offers good results when well indicated and performed with caution.