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https://www.readbyqxmd.com/read/27145310/symptomatic-treatment-for-uncomplicated-acute-diverticulitis-a-prospective-cohort-study
#1
Juha P Mali, Panu J Mentula, Ari K Leppäniemi, Ville J Sallinen
BACKGROUND: Even though evidence for nonantibiotic treatment of uncomplicated diverticulitis exists, it has not gained widespread adoption. OBJECTIVE: The aim of this prospective single-arm study was to analyze the safety and efficacy of symptomatic (nonantibiotic) treatment for uncomplicated diverticulitis during a 30-day follow-up period. DESIGN: This study is a single-arm prospective trial (ClinicalTrials.gov ID NCT02219698). SETTINGS: This study was performed at an academic teaching hospital functioning as both a tertiary and secondary care referral center...
June 2016: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/26989380/emergency-surgery-for-acute-complicated-diverticulitis
#2
REVIEW
Ferdinand Köckerling
BACKGROUND: The optimal treatment of acute complicated diverticulitis is a matter of debate and has undergone significant changes. Currently, the main focus of surgical treatment concepts is on controlling the emergency situation triggered by acute complicated sigmoid diverticulitis through interventional and minimally invasive measures. METHODS: This article presents the current data and recommendations on differentiated treatment of acute complicated sigmoid diverticulitis, which are also summarized in a decision tree...
April 2015: Viszeralmedizin
https://www.readbyqxmd.com/read/26797440/ectopic-human-fasciola-hepatica-infection-by-an-adult-worm-in-the-mesocolon
#3
Ah Jin Kim, Chang Hwan Choi, Sun Keun Choi, Yong Woon Shin, Yun-Kyu Park, Lucia Kim, Suk Jin Choi, Jee Young Han, Joon Mee Kim, Young Chae Chu, In Suh Park
We report here an ectopic case of Fasciola hepatica infection confirmed by recovery of an adult worm in the mesocolon. A 56-year-old female was admitted to our hospital with discomfort and pain in the left lower quadrant of the abdomen. Abdominal CT showed 3 abscesses in the left upper quadrant, mesentery, and pelvic cavity. On surgical exploration, abscess pockets were found in the mesocolon of the sigmoid colon and transverse colon. A leaf-like worm found in the abscess pocket of the mesocolon of the left colon was diagnosed as an adult fluke of F...
December 2015: Korean Journal of Parasitology
https://www.readbyqxmd.com/read/26791117/leukocytoclastic-vasculitis-associated-with-perforated-diverticular-disease
#4
Amalachukwu Michael Okpala, Meera Joshi, Brian Andrews
Leukocytoclastic vasculitis (LV) is a small vessel vasculitis associated with infections, connective tissue disease, malignancies and, rarely, gastrointestinal conditions. An association between LV and acute diverticulitis has not previously been reported. LV may be localised to the skin as a purpuric rash or might manifest with systemic involvement, such as of the joints, gastrointestinal tract or kidneys. Management of LV can be medical or surgical, based on the degree of systemic involvement. We present the case of a 56-year-old man with a 2-year history of a purpuric rash associated with diarrhoea, who presented acutely with abdominal pain...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/26484319/hemophagocytic-syndrome-a-dilemma-chasing-the-intensivists
#5
Adriana Façanha Queiroz, Gabriel Nuncio Benevides, Iracema de Cassia Oliveira Ferreira Fernandes, Patricia de Freitas Goes, Albert Bousso, Cristiane Rubia Ferreira
Hemophagocytic lymphohistiocytosis or hemophagocytic syndrome is represented by an uncontrolled inflammatory response characterized by marked histiocyte activation and a cytokine storm. The entity may present a primary or genetic type, and the secondary type is usually triggered by infectious diseases of any kind, autoimmune disease, or neoplasia. This entity, although well described and with definite diagnostic criteria, still remains misdiagnosed because of the overlap presentation with other inflammatory processes...
January 2015: Autopsy & case reports
https://www.readbyqxmd.com/read/26070499/reduced-dose-abdominopelvic-ct-using-hybrid-iterative-reconstruction-in-suspected-left-sided-colonic-diverticulitis
#6
Azien Laqmani, Simon Veldhoen, Simon Dulz, Thorsten Derlin, Cyrus Behzadi, Jakob Schmidt-Holtz, Felicia Wassenberg, Susanne Sehner, Hans-Dieter Nagel, Gerhard Adam, Marc Regier
OBJECTIVES: To assess the effect of hybrid iterative reconstruction (HIR) and filtered back projection (FBP) on abdominopelvic CT with reduced-dose (RD-APCT) in the evaluation of acute left-sided colonic diverticulitis (ALCD). METHODS: Twenty-five consecutive patients with suspected ALCD who underwent RD-APCT (mean CTDIvol 11.2 ± 4.2 mGy) were enrolled in this study. Raw data were reconstructed using FBP and two increasing HIR levels, L4 & L6. Two radiologists assessed image quality, image noise and reviewer confidence in interpreting findings of ALCD, including wall thickening, pericolic fat inflammation, pericolic abscess, and contained or free extraluminal air...
January 2016: European Radiology
https://www.readbyqxmd.com/read/25710425/staging-of-acute-diverticulitis-based-on-clinical-radiologic-and-physiologic-parameters
#7
Ville J Sallinen, Ari K Leppäniemi, Panu J Mentula
BACKGROUND: Acute diverticulitis is a broad spectrum of diseases with highly varying mortality and need for surgery. The aim of this study was to create an accurate staging of diverticulitis, which could be used both preoperatively and intraoperatively to predict outcome and guide treatment. METHODS: This was a retrospective study of patients treated for diverticulitis in a secondary and tertiary referral center. Multivariate analysis was performed on several clinical, radiologic, and physiologic parameters to find predictors of mortality, need for surgery, need for intensive care, and length of stay...
March 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/25058767/carcinoma-cecum-presenting-as-right-gluteal-abscess-through-inferior-lumbar-triangle-pathway-report-of-a-rare-case
#8
Vilvapathy Senguttuvan Karthikeyan, Sarath Chandra Sistla, Duvuru Ram, Sheik Manwar Ali, Sugi Subramaniam Raghavan Velayutham, Nandhagopal Vijayaraghavan
Gluteal abscess commonly follows intramuscular injections with contaminated needles. Carcinoma cecum is known to present with pericolic abscess due to microperforations and may rupture intraperitoneally. Gluteal abscess secondary to perforated carcinoma cecum with pericolic abscess is extremely uncommon. A 50-year-old woman who was receiving intramuscular iron injections for anemia presented with a 10×10-cm abscess in the right gluteal region and a vague mass in the right iliac fossa. After investigations, a diagnosis of perforated carcinoma cecum with pericolic abscess tracking into the right gluteal region was made, and incision and drainage were done...
July 2014: International Surgery
https://www.readbyqxmd.com/read/24901689/nonoperative-management-of-perforated-diverticulitis-with-extraluminal-air-is-safe-and-effective-in-selected-patients
#9
Ville J Sallinen, Panu J Mentula, Ari K Leppäniemi
BACKGROUND: The optimal treatment for diverticulitis with extraluminal air is controversial. OBJECTIVE: The purpose of this research was to evaluate the safety and effectiveness of nonoperative treatment of acute diverticulitis with extraluminal air. DESIGN: This was a retrospective cohort. SETTINGS: The study was conducted at an academic teaching hospital functioning as both a tertiary and secondary care referral center...
July 2014: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/24258427/minimally-invasive-and-surgical-management-strategies-tailored-to-the-severity-of-acute-diverticulitis
#10
REVIEW
F D McDermott, D Collins, A Heeney, D C Winter
BACKGROUND: The severity of acute diverticulitis ranges from mild, simple inflammation to pericolic abscesses, or perforation with faeculent peritonitis. Treatment of diverticulitis has evolved towards more conservative and minimally invasive strategies. The aim of this review is to highlight recent concepts and advances in management. METHODS: A literature review was performed on the electronic databases MEDLINE from PubMed, Embase and the Cochrane Library for publications in English...
January 2014: British Journal of Surgery
https://www.readbyqxmd.com/read/24192258/application-of-a-modified-neff-classification-to-patients-with-uncomplicated-diverticulitis
#11
L Mora Lopez, S Serra Pla, X Serra-Aracil, E Ballesteros, S Navarro
AIM: Severity of acute diverticulitis (AD) has traditionally been assessed using the Hinchey classification; however, this classification is predominantly a surgical one. The Neff classification provides an alternative classification based on CT findings. The aim of this study was to evaluate a modification of the Neff classification to select patients presenting with early-stage AD to receive outpatient management. METHOD: All patients with AD, presenting to a single unit, were prospectively studied...
November 2013: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/24178863/risk-of-colon-cancer-after-computed-tomography-diagnosed-acute-diverticulitis-is-routine-colonoscopy-necessary
#12
Ville Sallinen, Panu Mentula, Ari Leppäniemi
BACKGROUND: Current guidelines recommend computed tomography (CT) for diagnosing diverticulitis and for routine follow-up colonoscopy to rule out cancer. Scientific data to support routine colonoscopy after acute diverticulitis are scarce and conflicting. This study aimed to evaluate the risk of colon cancer mimicking diverticulitis, and hence the need for routine colonoscopy after CT-diagnosed acute diverticulitis. METHODS: This study was a retrospective analysis of patients treated for acute diverticulitis in a single academic institution during 2006-2010...
March 2014: Surgical Endoscopy
https://www.readbyqxmd.com/read/23969324/guidelines-of-diagnostics-and-treatment-of-acute-left-sided-colonic-diverticulitis
#13
REVIEW
Caroline S Andeweg, Irene M Mulder, Richelle J F Felt-Bersma, Annelies Verbon, Gert Jan van der Wilt, Harry van Goor, Johan F Lange, Jaap Stoker, Marja A Boermeester, Robert P Bleichrodt
BACKGROUND: The incidence of acute left-sided colonic diverticulitis (ACD) is increasing in the Western world. To improve the quality of patient care, a guideline for diagnosis and treatment of diverticulitis is needed. METHODS: A multidisciplinary working group, representing experts of relevant specialties, was involved in the guideline development. A systematic literature search was conducted to collect scientific evidence on epidemiology, classification, diagnostics and treatment of diverticulitis...
2013: Digestive Surgery
https://www.readbyqxmd.com/read/23918084/acute-and-elective-laparoscopic-resection-for-complicated-sigmoid-diverticulitis-clinical-and-histological-outcome
#14
Marty Zdichavsky, Thomas Kratt, Dietmar Stüker, Tobias Meile, Maximilian V Feilitzsch, Dörte Wichmann, Alfred Königsrainer
BACKGROUND: Surgical treatment of acute complicated sigmoid diverticulitis is still under debate while elective treatment of recurrent diverticulitis has proven benefits. The aim of this study was to evaluate the clinical and histological outcome of acute and elective laparoscopic sigmoid colectomy in patients with diverticulitis. METHODS: A retrospective review was conducted where 197 patients were analyzed undergoing laparoscopic sigmoid resection for acute complicated diverticulitis and recurrent diverticulitis...
November 2013: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/23898385/risk-factors-for-severe-diverticulitis-in-computed-tomography-confirmed-acute-diverticulitis-in-korea
#15
Nark-Soon Park, Yoon Tae Jeen, Hyuk Soon Choi, Eun Sun Kim, Young Jin Kim, Bora Keum, Yeon Seok Seo, Hoon Jai Chun, Hong Sik Lee, Soon Ho Um, Chang Duck Kim, Ho Sang Ryu
BACKGROUND/AIMS: Acute complicated diverticulitis can be subdivided into moderate diverticulitis and severe diverticulitis. Although there have been numerous studies on the risk factors for complicated diverticulitis, little research has focused on severe diverticulitis. This study was designed to identify the risk factors for severe diverticulitis in an acute diverticulitis attack using the modified Hinchey classification. METHODS: Patients were included if they had any evidence of acute diverticulitis detected by computed tomography...
July 2013: Gut and Liver
https://www.readbyqxmd.com/read/23575295/-summary-of-the-practice-guideline-on-diverticulitis-in-the-colon-diagnostics-and-treatment-in-specialty-care
#16
REVIEW
Caroline S Andeweg, Richelle J F Felt-Bersma, Annelies Verbon, Jaap Stoker, Marja A Boermeester, Robert P Bleichrodt
The natural course of diverticulitis is usually mild and often requires only conservative treatment. The combination of pain in the lower left abdomen on physical examination, the absence of vomiting and a CRP > 50 mg/l is highly predictive of diverticulitis; further investigation by means of imaging may then be omitted. An initial ultrasound - and CT scanning only if this investigation proves negative or inconclusive - provides the best results in terms of imaging. There is no evidence substantiating the efficacy of routine antibiotic administration to patients with clinically mild and uncomplicated diverticulitis...
2013: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/23294948/therapeutical-options-in-sigmoid-diverticulitis-when-should-we-operate
#17
Tr Pătraşcu, H Doran, E Catrina, O Mihalache
Colonic diverticulosis is a benign disease whose incidence has been steadily increasing throughout the world, especially in the economically developed countries in Western Europe. This increase is connected to the population ageing process, the diverticulosis being characteristic in the elderly, and with nowadays' eating habits. Frequently, colonic diverticuli may cause complications, such as hemorrhage or diverticulitis, with pericolic abscesses or peritonitis. Consequently, efforts are being made to set up a therapeutic algorithm appropriate for the diverticular disease, the predominance of the conservative or surgical attitude being continuously adjusted...
November 2012: Chirurgia
https://www.readbyqxmd.com/read/22982746/diverticular-disease-eat-your-fiber
#18
Jeannette Y Wick
In industrialized nations, diverticular disease affects up to 70% of individuals by 60 years of age, with symptoms that can range from mild gastrointestinal disturbance to incapacitating pain. Diverticular disease appears to be related to increasing affluence and changed diet: Current theory holds that diverticular disease's origin is low-fiber diet. This explains why its incidence is highest and accelerating in the more prosperous countries where intake of fiber has decreased and intake of milled grains and refined sugars has increased over time...
September 2012: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/22549495/danish-national-guidelines-for-treatment-of-diverticular-disease
#19
Jens Christian Andersen, Lars Bundgaard, Henrik Elbrønd, Søren Laurberg, Line Rosell Walker, Jens Støvring
In order to elaborate evidence-based, national Danish guidelines for the treatment of diverticular disease the literature was reviewed concerning the epidemiology, staging, diagnosis and treatment of diverticular disease in all its aspects. The presence of colonic diverticula, which is considered to be a mucosal herniation through the intestinal muscle wall, is inversely correlated to the intake of dietary fibre. Other factors in the genesis of diverticular disease may be physical inactivity, obesity, and use of NSAIDs or acetaminophen...
May 2012: Danish Medical Journal
https://www.readbyqxmd.com/read/22046799/-rare-clinical-situatons-of-the-diverticuli-of-the-colon
#20
C Diaconu, C Dogaru, Roxana Livadariu, A Gervescu, F Grecu, C Bulat
UNLABELLED: It is well known that the diverticuli of the colon gets inflamed in 10-15% of cases, thus becoming clinical symptomatic as a diverticulitis, while in other 15% they will bleed, with the clinical aspect of an inferior digestive bleeding. Our study presents some clinical observations with diverticuli of the colon, that raised diagnostic and therapeutic problems. MATERIAL AND METHOD: Between 2001-2010, 17 patients were admitted in the 3rd Surgery Clinic, University Hospital "St...
July 2011: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
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