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pericolic abscess

Stefan T van Dijk, Sabrina A N Doelare, Anna A W van Geloven, Marja A Boermeester
BACKGROUND: Although approximately 15% of all patients with acute colonic diverticulitis have pericolic extraluminal air found on computed tomography (CT), studies on the natural course and treatment of these patients are scarce. It is not clear whether these patients behave as mild uncomplicated diverticulitis or as severe diverticulitis needing more aggressive treatment. Consequently, there is no consensus about the treatment, guidelines do not discuss this group of patients, and physicians treat these patients based on their own experiences and opinion...
May 2018: Surgical Infections
Iosief Abraha, Gian A Binda, Alessandro Montedori, Alberto Arezzo, Roberto Cirocchi
BACKGROUND: Diverticular disease is a common condition in Western industrialised countries. Most individuals remain asymptomatic throughout life; however, 25% experience acute diverticulitis. The standard treatment for acute diverticulitis is open surgery. Laparoscopic surgery - a minimal-access procedure - offers an alternative approach to open surgery, as it is characterised by reduced operative stress that may translate into shorter hospitalisation and more rapid recovery, as well as improved quality of life...
November 25, 2017: Cochrane Database of Systematic Reviews
S T van Dijk, L Daniels, C Y Nio, I Somers, A A W van Geloven, M A Boermeester
PURPOSE: Since outpatient treatment and omitting antibiotics for uncomplicated acute colonic diverticulitis have been proven to be safe in the majority of patients, selection of patients that may not be suited for this treatment strategy becomes an important topic. The aim of this study is to identify computed tomography (CT) imaging predictors for a complicated disease course of initially uncomplicated acute diverticulitis. METHODS: CT imaging from a randomized controlled trial (DIABOLO study) of an observational vs...
December 2017: International Journal of Colorectal Disease
Dong Hwan Kim, Hyuk Jung Kim, Suk Ki Jang, Jae Woo Yeon, Kyung Sook Shin
OBJECTIVE: The purpose of this study was to retrospectively assess CT predictors of unfavorable outcomes of medical treatment in patients with right colonic diverticulitis. MATERIALS AND METHODS: Of 394 patients with right colonic diverticulitis diagnosed on the basis of CT findings from January 2010 through August 2013, we included 328 (190 men, 138 women; mean age, 41.3 ± 12.6 years) who had undergone medical treatment as inpatients. Two radiologists retrospectively reviewed the following CT findings associated with diverticulitis: number of diverticula per 10 cm of colon; length and thickness of affected colonic wall; diameter of inflamed diverticulum and abscess; presence of pericolic fluid collection, spilled feces, and contained air; and extent of fatty infiltration...
December 2017: AJR. American Journal of Roentgenology
Kunal Kothari, Barak Friedman, Gregory M Grimaldi, John J Hines
Large bowel perforation is an abdominal emergency that results from a wide range of etiologies. Computed tomography is the most reliable modality in detecting the site of large bowel perforation. The diagnosis is made by identifying direct CT findings such as extraluminal gas or contrast and discontinuity along the bowel wall. Indirect CT findings can help support the diagnosis, and include bowel wall thickening, pericolic fat stranding, abnormal bowel wall enhancement, abscess, and a feculent collection adjacent to the bowel...
November 2017: Abdominal Radiology
Ju Hwa Min, Hyun Cheol Kim, Sang Won Kim, Dal Mo Yang, Sun Jung Rhee, Jiyoung Oh, Sung Eun Ahn
PURPOSE: The purpose of the study was to assess the value of initial sonography in the diagnosis of right-sided colonic diverticulitis in comparison with supplementary CT. MATERIALS AND METHODS: A total of 183 consecutive adult patients with right lower quadrant pain (73 diverticulitis, and 110 non-diverticulitis) who underwent both initial sonography and subsequent CT within 24 h were enrolled in this study. Two reviewers retrospectively assessed imaging findings of diverticula, colonic wall thickening, inflammatory pericolic fat, and pericolic abscess for each sonography and CT and then classified each case as non-diverticulitis, simple diverticulitis or complicated diverticulitis...
July 2017: Japanese Journal of Radiology
Anne-Marie E Sirany, Wolfgang B Gaertner, Robert D Madoff, Mary R Kwaan
BACKGROUND: Inpatient treatment of patients with colon diverticulitis represents a significant financial and clinical burden to the health care system and patients. The aim of this study was to compare patients with diverticulitis in the emergency department (ED), who were discharged to home vs admitted to the hospital. STUDY DESIGN: We reviewed all patients evaluated in the ED of a metropolitan health system, with the primary diagnosis of diverticulitis (ICD-9 562...
July 2017: Journal of the American College of Surgeons
Kashvi Gupta, Shibumon M Madhavan, Alfred J Augustine
No abstract text is available yet for this article.
2017: ACG Case Reports Journal
Kavita Darji, Maulik M Dhandha, Mary Guo
Hidradenitis suppurativa (HS) is a chronic skin disorder of the terminal follicular epithelium of apocrine sweat glands, manifesting as painful and exudative papules, pustules, cysts or nodules. This inflammatory condition often presents with other systemic and cutaneous disorders. We present the case of an African-American man with HS who was also diagnosed with neutrophilic dermatoses and diverticular disease. Neutrophilic dermatosis was identified based on histopathology findings. Our patient underwent multiple surgeries for flaring of his skin condition...
February 10, 2017: BMJ Case Reports
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 ( 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
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
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
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...
January 20, 2016: BMJ Case Reports
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
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
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
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
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
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
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
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