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Diverticular diseases

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https://www.readbyqxmd.com/read/28634627/influence-of-multiple-stapler-firings-used-for-rectal-division-on-colorectal-anastomotic-leak-rate
#1
Tamara Braunschmid, Nikolaus Hartig, Lukas Baumann, Bernhard Dauser, Friedrich Herbst
BACKGROUND: Anastomotic leakage following colorectal resection remains one of the most significant complications with relevant morbidity and mortality. There is evidence that a higher number of stapler firings for rectal division can affect the leak rate in double stapling anastomosis. However, there are no data concerning compression anastomosis. We present our institutional experience addressing this issue. DESIGN: This is a retrospective review of a prospective institutional database of patients undergoing colonic and rectal resection for benign and malignant indications between January 2008 and December 2014 at the surgical department of the St...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28630808/management-of-acute-uncomplicated-diverticulitis-may-exclude-antibiotic-therapy
#2
REVIEW
Jonathan Mayl, Mikhail Marchenko, Emily Frierson
Diverticulitis is a common ailment that is prevalent in the developed world. As such, the management of diverticulitis places a substantial economic burden on healthcare. Research is ongoing to further elucidate both the pathogenesis of the disease, as well as ways to reduce associated expenditures. One of these emerging areas of research calls into question the use of antibiotics during treatment of acute uncomplicated diverticulitis. Current guidelines are largely based on expert opinion, with little evidence supporting the standard practice of antibiotic therapy...
May 15, 2017: Curēus
https://www.readbyqxmd.com/read/28630219/a-rare-case-of-sigmoid-colon-perforation-with-subsequent-psoas-abscess-collection-with-extensive-involvement-of-the-sartorius-muscle
#3
Ali Wadood, Abdulrahman Odeh, Khizer Rana, Shafquat Zaman
A middle-aged man was admitted with worsening hip pain, fevers and reduced mobility. These symptoms were preceded by a mechanical fall but despite regular analgesia, symptoms did not resolve. His prior medical history included ischaemic heart disease, hypertension and hypercholesterolaemia. A trauma and orthopaedic review revealed a painful left hip with reduced range of motion. In addition, some mild tenderness in the left iliac fossa was noted. Blood tests revealed markedly raised inflammatory markers. Plain radiographs and ultrasound were normal...
June 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28627445/right-sided-acute-diverticulitis-a-single-western-center-experience
#4
Francesco Monari, Maurizio Cervellera, Basilio Pirrera, Umberto D'Errico, Samuele Vaccari, Laura Alberici, Valeria Tonini
INTRODUCTION: Right sided diverticular disease is a rare condition in Western countries whereas is common amongst Asian population. The aim of this study is to evaluate options and outcomes for the treatment of right colonic diverticulitis. METHOD: We included only patients undergoing surgery with right colon diverticulitis (RCD) proven at histological specimen examination from September 2011 to December 2016. RESULTS: We performed 18 operations for RCD...
June 13, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28611560/gallstone-ileus-caused-by-cholecystocolonic-fistula-and-gallstone-impaction-in-the-sigmoid-colon-review-of-the-literature-and-novel-surgical-treatment-with-trephine-loop-colostomy
#5
James W O'Brien, Lucy-Anne Webb, Luke Evans, Chris Speakman, Irshad Shaikh
Gallstone ileus is an uncommon cause of intestinal obstruction and occurs following the formation of a cholecystoenteric fistula, permitting passage of gallstones into the gastrointestinal tract. Impaction of a gallstone in the sigmoid colon is rare and is usually at sites of previous colonic disease. Definitive management can be challenging due to the advanced age and co-morbidity usually seen in this group of patients. We describe a patient successfully managed with on-table endoscopy and, under local anaesthetic, the formation of a left iliac fossa trephine loop colostomy, permitting an enterolithotomy to deliver the stone whilst accommodating for severe pre-existing distal sigmoid diverticular disease...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28608124/-diverticulitis-domain-of-conservative-or-drug-therapy
#6
REVIEW
S Böhm, W Kruis
Increasing interest in diverticular disease by the scientific community in the last 10-15 years has resulted in an increased number of publications. Among other things, nonevidence-based therapeutic paradigms were tested in randomized, controlled therapy studies. The importance of surgery in the therapy of diverticulitis has diminished in recent years; in particular, it has no role in the treatment of diverticulitis types 1a, 1b, and 2a according to the Classification of Diverticular Disease (CDD) treated successfully by conservative means...
June 12, 2017: Der Internist
https://www.readbyqxmd.com/read/28585551/sequence-variants-in-arhgap15-colq-and-fam155a-associate-with-diverticular-disease-and-diverticulitis
#7
Snaevar Sigurdsson, Kristjan F Alexandersson, Patrick Sulem, Bjarke Feenstra, Steinunn Gudmundsdottir, Gisli H Halldorsson, Sigurgeir Olafsson, Asgeir Sigurdsson, Thorunn Rafnar, Thorgeir Thorgeirsson, Erik Sørensen, Andreas Nordholm-Carstensen, Jakob Burcharth, Jens Andersen, Henrik Stig Jørgensen, Emma Possfelt-Møller, Henrik Ullum, Gudmar Thorleifsson, Gisli Masson, Unnur Thorsteinsdottir, Mads Melbye, Daniel F Gudbjartsson, Tryggvi Stefansson, Ingileif Jonsdottir, Kari Stefansson
Diverticular disease is characterized by pouches (that is, diverticulae) due to weakness in the bowel wall, which can become infected and inflamed causing diverticulitis, with potentially severe complications. Here, we test 32.4 million sequence variants identified through whole-genome sequencing (WGS) of 15,220 Icelanders for association with diverticular disease (5,426 cases) and its more severe form diverticulitis (2,764 cases). Subsequently, 16 sequence variants are followed up in a diverticular disease sample from Denmark (5,970 cases, 3,020 controls)...
June 6, 2017: Nature Communications
https://www.readbyqxmd.com/read/28578700/a-rare-presentation-of-an-acute-abdomen-an-ileal-diverticular-perforation
#8
Basuru Uvindu Thilakawardana, Sanjay De Mel, Vasitha Abeysuriya, Janaki Hewavisenthi, Chandima De Mel, Lal Chandrasena, Visula Abeysuriya
BACKGROUND: This case report highlights the value of prompt intervention of diagnostic laparoscopy in a patient suspects of having an acute abdomen due to an intestinal perforation, where there is a limitation of performing Contrast Enhanced Computed Tomography of abdomen. A previously healthy young adult presenting with an acute abdomen due to a spontaneous ileal perforation, without any associated risk factors is a rare clinical entity in a developing country. Therefore, entertaining an early diagnosis will possibly prevent a fatal consequence...
June 2, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28556447/tobacco-smoking-and-the-risk-of-diverticular-disease-a-systematic-review-and-meta-analysis-of-prospective-studies
#9
REVIEW
D Aune, A Sen, M F Leitzmann, S Tonstad, T Norat, L J Vatten
AIM: This systematic review and meta-analysis aimed to clarify whether tobacco smoking is associated with an increased risk of diverticular disease. METHODS: PubMed and Embase databases were searched for studies of smoking and diverticular disease up to February 19, 2016. Prospective studies that reported adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) of diverticular disease associated with current, r or previous smoking were included. Summary RRs were estimated using a random effects model...
May 26, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28548199/-acute-small-bowel-diverticulitis-in-a-patient-with-crohn%C3%A2-s-disease
#10
Macarena Hevia, Rodrigo Quera, Leonardo Soto, Tomás Regueira, Andrés O'Brien, Andrés Larach, Udo Kronberg
Diverticular disease of the small intestine is rare, especially when it is located in the jejunum. It is generally asymptomatic, but in some patients it may have complications such as acute diverticulitis with peritonitis, gastrointestinal bleeding or obstruction. In such cases, the recommended treatment is surgery. We report a 77-year-old patient with ileal Crohn’s disease with a long-standing inflammatory phenotype, who developed acute diverticulitis of the jejunum presenting a severe septic shock and secondary multiple-organ failure...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28528364/a-randomized-double-blind-placebo-controlled-trial-of-a-multi-strain-probiotic-in-treatment-of-symptomatic-uncomplicated-diverticular-disease
#11
Charlotte L Kvasnovsky, Ingvar Bjarnason, Ana Nora Donaldson, Roy A Sherwood, Savvas Papagrigoriadis
BACKGROUND: Diverticular disease is a significant burden on healthcare systems that is managed, surgically or medically, mainly as an emergency or acute condition. There are no standardized treatment recommendations for symptomatic uncomplicated disease. We hypothesized that a probiotic would reduce abdominal pain in such patients. METHODS: We conducted a single-center, double-blind, placebo-controlled trial of probiotic treatment (Symprove) in adult patients with moderate-to-severe chronic, non-acute symptomatic diverticular disease...
May 20, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28523327/complicated-diverticulitis-in-a-de-novo-kidney-transplanted-patient
#12
Liliana Ana TuŢă, Mădălina Boşoteanu, Eugen Dumitru, Mariana Deacu
Diverticular disease is frequent amongst the elderly and immunosuppressed patients. It mainly presents as sigmoid diverticulitis, but severe complications, like bleedings, infections and colon perforation may occur, frequently due to immunosuppressive therapy. Moreover, antibiotherapy and hemostatics may not efficiently control evolution in such cases. Early diagnose and adequate treatment of colonic diverticulosis complicated with lower gastrointestinal bleeding and diverticulitis in immunocompromised patients...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28503973/metformin-use-in-diabetics-with-diverticular-disease-is-associated-with-reduced-incidence-of-diverticulitis
#13
Julia Freckelton, Jacqueline Amanda Evans, Daniel Croagh, Gregory Thomas Moore
BACKGROUND AND AIMS: There is no current, evidence-based therapy to prevent acute diverticulitis in patients with diverticular disease. Metformin has been shown to have anti-inflammatory effects in a number of disease states, in both animal models and in human observational studies. The potential therapeutic efficacy of metformin in diverticular disease has not been investigated. This study aims to describe the relationship between metformin use and diverticular disease in patients with diabetes mellitus...
May 14, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28494576/diverticular-disease-an-update-on-pathogenesis-and-management
#14
REVIEW
Mona Rezapour, Saima Ali, Neil Stollman
Diverticular disease is one of the most common conditions in the Western world and one of the most common findings identified at colonoscopy. Recently, there has been a significant paradigm shift in our understanding of diverticular disease and its management. The pathogenesis of diverticular disease is thought to be multifactorial and include both environmental and genetic factors in addition to the historically accepted etiology of dietary fiber deficiency. Symptomatic uncomplicated diverticular disease (SUDD) is currently considered a type of chronic diverticulosis that is perhaps akin to irritable bowel syndrome...
May 12, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28469355/segmental-colitis-associated-with-diverticulosis-is-it-the-coexistence-of-colonic-diverticulosis-and-inflammatory-bowel-disease
#15
REVIEW
John Schembri, John Bonello, Dimitrios K Christodoulou, Konstantinos H Katsanos, Pierre Ellul
Segmental colitis associated with diverticulosis (SCAD) is an inflammatory process that affects colonic luminal mucosa in segments that are also affected by diverticulosis. Its prevalence varies between 1.15% and 11.4% amongst those suffering from diverticular disease (DD). Being closely associated with DD, it is slightly commoner in males and usually presents in the sixth decade of life. Although the exact pathogenesis of SCAD is unknown, it is probably heterogeneous and includes mechanisms that also play a part in inflammatory bowel disease (IBD)...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28467330/diagnosis-of-symptomatic-uncomplicated-diverticular-disease-and-the-role-of-rifaximin-in-management
#16
Giovanni Maconi
 Patients with diverticulosis who develop persistent abdominal pain, bloating and changes in bowel habits not associated with overt inflammation may have symptomatic uncomplicated diverticular disease (SUDD). The severity and frequency of SUDD symptoms may have an impact on daily activities and severely affect quality of life. Effective management of SUDD should follow a three part strategy: divert, tackle and maintain. Divert to make the correct diagnosis: several symptoms of SUDD are common to other conditions that require different therapeutic approaches...
April 28, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28466633/the-current-management-of-diverticulosis
#17
Walter Elisei, Giovanni Brandimarte, Antonio Tursi
The incidence of diverticulosis and diverticular disease of the colon, including acute diverticulitis, is increasing worldwide, and becoming a significant burden on national health systems in terms of direct and indirect costs. Thus, significant efforts are now being focused to identify the correct therapeutic approach to treat symptomatic patients and to prevent diverticulitis. Fibre, non- absorbable antibiotics, 5-aminosalicylic acid and probioticsare currently being investigated in this way. Unfortunately, current evidences on the effectiveness of some medical treatment in preventing acute diverticulitis recurrence are still lacking...
May 2, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28463672/genito-urinary-function-and-quality-of-life-after-elective-totally-laparoscopic-sigmoidectomy-after-at-least-one-episode-of-complicated-diverticular-disease-according-to-two-different-vascular-approaches-the-ima-low-ligation-or-the-ima-preservation
#18
Giulio Mari, Jacopo Crippa, Andrea Costanzi, Michele Mazzola, Carmelo Magistro, Giovanni Ferrari, Dario Maggioni
The arterial ligation during elective laparoscopic sigmoidectomy for diverticular disease can affect genito-urinary function injuring the superior hypogastric plexus, and can weaken the distal colonic stump arterial perfusion. Ligation of the inferior mesenteric artery distal to the left colic artery or the complete preservation of the inferior mesenteric artery can therefore be compared in terms of preservation of the descending sympathetic fibres running along the aorta to the rectum resulting in a different post operative genito urinary function...
March 2017: Chirurgia
https://www.readbyqxmd.com/read/28461904/corticosteroid-use-and-mortality-risk-in-patients-with-perforated-colonic-diverticular-disease-a-population-based-cohort-study
#19
L H A Broersen, E Horváth-Puhó, A M Pereira, R Erichsen, O M Dekkers, H T Sørensen
BACKGROUND: Corticosteroids are a potential risk factor for mortality in patients with perforated diverticular disease, due to blinding of disease severity, hampered wound healing or adrenal insufficiency. We examined mortality in corticosteroid users and non-users among patients with perforated diverticular disease. METHODS: A cohort study based on medical databases including all patients ≥18 years in Denmark (source population 5 289 261 inhabitants) admitted to a hospital with incident perforated diverticular disease between 2005 and 2013...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/28458843/sigmoid-gluteal-fistula-a-rare-complication-of-fistulating-diverticular-disease
#20
Thomas Chadwick, Ashok Katti, James Arthur
A rare complication of diverticular disease is the formation of fistulas, most commonly either colo-vesical or colo-vaginal. We present the unusual case of a perforated sigmoid diverticulum forming a colo-gluteal fistula and presenting initially as a gluteal abscess in an otherwise asymptomatic patient. After drainage of the gluteal abscess, the patient re-presented with faecal loss from the abscess drainage site. Imaging revealed fistulous communication between the sigmoid and the left obturator internus muscle, tracking to the gluteus maximus with associated abscess and cutaneous communication to the site of previous drainage...
March 2017: Journal of Surgical Case Reports
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