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The population of Finland is aging fast, and dietary fiber consumption has decreased during the past few decades; the prevalence of sigmoid diverticular perforation can therefore be anticipated to increase. This study presents our experience concerning the outcome of 133 patients admitted to a university hospital for diverticular perforation during a 15-year period.One hundred thirty-three patients admitted into our hospital for sigmoid diverticular perforation during the 15-year period from 1986 to 2000 were identified using a computer database. Clinical data were reviewed from the database and the patients' records.The annual prevalence of perforated sigmoid diverticulitis is increasing. It was 2.4 per 100,000 in the year 1986 and 3.8 per 100,000 in the year 2000. The resection rate was 90 percent; after resection, 45 primary anastomoses, 75 Hartmann's colostomies, and 1 covering colostomy were performed. The overall complication rate was 32 percent, without any significant difference between the procedures. Of the clinical variables, the Mannheim Peritonitis Index scores (P= 0.0088) and the number of previous hospital treatments (P= 0.035) correlated with postoperative complications. Overall mortality was 9 percent, without any significant difference between the procedures. Of the clinical variables, the Mannheim Peritonitis Index scores correlated with mortality. Of the 12 patients who died, 11 had Mannheim Peritonitis Index scores of 21 or more(P= 0.0001). Forty-five percent of the colostomies have been closed.The prevalence of perforated sigmoid diverticulitis is increasing in northern Finland. Mannheim Peritonitis Index score can be used in predicting the outcome of patients admitted for perforated sigmoid diverticulitis.