- Laparoscopic resection of a giant colonic diverticulum - The "lifting balloon sign" video vignette. [Letter]
- CDColorectal Dis 2019 May 23
- Giant colonic diverticulum represents a rare manifestation of diverticular disease. Less than 200 cases have been published to date. They are defined as colonic diverticula greater than 4 cm in size.…
Giant colonic diverticulum represents a rare manifestation of diverticular disease. Less than 200 cases have been published to date. They are defined as colonic diverticula greater than 4 cm in size. Most of them (~90%) arise from the sigmoid colon and are associated with concomitant diverticular disease (~85%). In a recent systematic review, the most common symptoms were abdominal pain, constipation, abdominal mass, vomiting and diarrhoea. Acute complications such as perforation, are a common presentation (26.5% of cases). A unidirectional ball-valve mechanism through a minimal communicating diverticular neck is a proposed theory for the pathogenesis. This article is protected by copyright. All rights reserved.
- Management of jejunal diverticulitis. Experience in our center. [Journal Article]
- CCCir Cir 2018; 86(2):130-133
- Jejunal diverticular disease is a very uncommon pathology often asymptomatic. Associated complications appear in less than 30% of patients and they can present as diverticulitis, refractary inflammat…
Jejunal diverticular disease is a very uncommon pathology often asymptomatic. Associated complications appear in less than 30% of patients and they can present as diverticulitis, refractary inflammation, obstruction, hemorrhage, perforation or intraabdominal abscess formation. Clinical manifestations are usually unspecific and high suspicion index is required to reach the diagnosis. Treatment of complications includes volume replacement, transfusions, antibiotic therapy, percutaneous drainage or surgical intervention. We present a retrospective observational study of the cases treated in our hospital between 2007 and 2016.
- Symptomatic Uncomplicated Diverticular Disease and Incidence of Unexpected Abscess during Sigmoidectomy: A Multicenter Prospective Observational Study. [Journal Article]
- DSDig Surg 2019 May 22; :1-6
- CONCLUSIONS: Our series of patients affected by symptomatic uncomplicated diverticular disease showed an incidence of unexpected pericolic or intramural abscess of 47.5%. Patients affected by smoldering diverticular disease presented a greater abscess rate.
- Therapeutic strategies for perforated jejunal diverticulitis. A case report. [Journal Article]
- AIAnn Ital Chir 2019 May 07; 8
- CONCLUSIONS: Jejunal diverticulosis often presents with non-specific symptoms like intermittent abdominal pain, dyspepsia, bloating or abdominal fullness and constipation. When, instead, it incurs a complication, it presents with an acute abdominal pain. The most frequent complication of jejunal diverticulitis is the perforation, followed by acute intestinal obstruction and diverticular bleeding. The diverticular perforation is associated with a high mortality, especially among elderly patients. Nowadays the mortality is reduced because of the improvement of the diagnostic, pharmaceutical and surgical protocols.With this report we want to discuss about different therapeutic approaches for perforated jejuno-ileal diverticula, which depends on the severity of the disease and the general clinical condition of the patient.
- [Gastrointestinal comorbidity and symptoms associated with depression in patients aged over 60 years]. [Journal Article]
- SSemergen 2019 May 16
- CONCLUSIONS: Gastrointestinal comorbidity is very common in patients over 60 years-old with depression. Three-quarters of the patients have chronic gastrointestinal diseases or symptoms. The conditions with strongest associations are irritable bowel syndrome, congenital anomalies, other peptic ulcers, and diverticular disease. The symptoms with strongest associations are anorexia, nausea/vomiting, constipation, flatulence, dysphagia, abdominal pain, dyspepsia, and heartburn.
- Small intestinal diverticula. [Editorial]
- TATer Arkh 2019 Mar 17; 91(2):4-8
- The prevalence of small intestinal diverticula (SID) in the population is 0.5-2.3%, and in most cases they are asymptomatic. In the presence of small intestinal bacterial overgrowth this results in c…
The prevalence of small intestinal diverticula (SID) in the population is 0.5-2.3%, and in most cases they are asymptomatic. In the presence of small intestinal bacterial overgrowth this results in chronic diarrhea and malabsorption. When it is complicated by diverticulitis it causes pain and other symptoms of inflammatory bowel disease. Inflammatory process progression may be accompanied by bleeding, invagination, intestinal obstruction, diverticulum abscess and perforation with peritonitis development. SID include separate nosological forms such as paraphateral diverticulum and Meckel's diverticulum. In diagnosis of SID ray and endoscopic methods are crucial. The basis of small intestine diverticular disease treatment is intestinal antiseptics, antibiotics as well as surgical intervention for severe complications. Two cases are discussed, the first one confirms a possibility of development of severe malabsorption syndrome with chronic diarrhea, and the second one is a complication in a form of severe diverticulitis, abscess with perforation and peritonitis.
- Novel Swine Model of Colonic Diverticulosis. [Journal Article]
- AJAm J Physiol Gastrointest Liver Physiol 2019 May 15
- The pathophysiology of colonic diverticulosis has not been completely understood. The development of appropriate animal models is essential to study diverticular disease. To date, no large animal mod…
The pathophysiology of colonic diverticulosis has not been completely understood. The development of appropriate animal models is essential to study diverticular disease. To date, no large animal models are available for this disease condition. The objective of this study is to develop a swine model by damaging of colon wall, combined with or without low fiber diet to mimic the pathogenesis of diverticulosis. To create a weakness on the colon wall, collagenase was applied in vivo to degrade the collagen in the colon wall. Three groups of Yucatan minipigs were included: Group 1 (n=12) underwent collagenase injection (CI) with low fiber diet for 6 months. Group 2 (n=8) underwent CI alone with standard swine diet for 6 months. Group 3 (n=12) received low fiber diet alone for 6 months. We found that diverticulosis occurred in 91.7% (11/12) of pigs in CI+diet group and 100% (8/8) in CI alone group. Moreover, around 30-75% of colon CI spots for each pig developed diverticular lesions. Diet alone for 6 months did not induce diverticulosis. The endoscopic and histological examinations revealed the formation of multiple wide-mouthed diverticular lesions along the descending colon. Our results provide convincing evidence of the high efficacy of the reduced colon wall strength caused by CI in the development of a swine model of diverticulosis. Low fiber diet consumption for 6 months had no influence on the generation time and incidence rate of diverticulosis. In this model, digestion of the collagen in the colonic wall is sufficient to cause diverticulosis.
- StatPearls: Colon Diverticulitis [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Diverticulitis has increased in incidence over the past few decades, becoming a major healthcare burden for Western countries. In the United States, acute diverticulitis results in nearly 200000 h…
Diverticulitis has increased in incidence over the past few decades, becoming a major healthcare burden for Western countries. In the United States, acute diverticulitis results in nearly 200000 hospital admissions and $2.2 billion of health care costs per year. Although the prevalence of the disease increases with age, younger adults may also develop diverticular disease. In fact, for some time, it was thought that younger patients and male patients were more likely to experience a more aggressive form of diverticulitis with an increased complication rate and higher recurrence. However, recent studies have challenged this concept. Environmental and genetic risk factors result in the development of diverticular disease, although good quality evidence for many of these factors remains insufficient. Most cases of diverticulitis undergo successful management in the outpatient setting with oral antibiotics and temporary dietary restrictions. The decision to perform elective sigmoid colectomy in patients that recover from uncomplicated diverticulitis is controversial and requires case-by-case consideration. Surgical treatment is the recommendation in cases of complicated diverticulitis.
- Surgeon, Hospital, and Geographic Variation in Minimally Invasive Colectomy. [Journal Article]
- AnnSAnn Surg 2019; 269(6):1109-1116
- CONCLUSIONS: Wide surgeon variation exists regarding an MIS approach for colectomy, and most of the total variation is attributable to individual surgeon practices-much of which is related to year of graduation. As increasing surgeon age is inversely proportional to the rate of MIS, patient referral and/or providing tailored training to older surgeons may be constructive targets in increasing the use of MIS and reducing healthcare utilization.
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- Giant pneumosalpinx secondary to colonic diverticular disease. [Journal Article]
- AJANZ J Surg 2019 May 12