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William F Paolo, Rhonaldo Silaban, Long Nguyen, Susan Wojcik, William Grant
OBJECTIVE: Computerized tomography (CT) is often employed to diagnose or rule out certain suspected abdominal pathologies. The aim of this study is to compare emergency physicians' estimated post-test disease probabilities to the probabilities obtained for similar diagnostic tests as reported in the literature. METHODS: Physicians were asked to estimate pre and posttest probabilities before and after CT scan results in patients with nontraumatic abdominal and pelvic pain...
February 27, 2018: American Journal of Emergency Medicine
Jacqueline J Blank, Abby E Rothstein, Cheong Jun Lee, Michael J Malinowski, Brian D Lewis, Timothy J Ridolfi, Mary F Otterson
Aortic graft infections are a rare but devastating complication of aortic revascularization. Often infections occur due to contamination at the time of surgery. Iatrogenic misplacement of the limbs of an aortobifemoral graft is exceedingly rare, and principles of evaluation and treatment are not well defined. We report 2 cases of aortobifemoral bypass graft malposition through the colon. CASE REPORT: Case 1 is a 54-year-old male who underwent aortobifemoral bypass grafting for acute limb ischemia...
January 1, 2018: Vascular and Endovascular Surgery
Abdullateef Abdulkareem, Ryan S D'Souza, Joshua Mundorff, Pragya Shrestha, Oluwaseun Shogbesan, Anthony Donato
Acquired angioedema due to C1 inhibitor deficiency (C1INH-AAE) is a rare and potentially fatal syndrome of bradykinin-mediated angioedema characterized by episodes of angioedema without urticaria. It typically manifests with nonpitting edema of the skin and edema in the gastrointestinal (GI) tract mucosa or upper airway. Edema of the upper airway and tongue may lead to life-threatening asphyxiation. C1INH-AAE is typically under-diagnosed because of its rarity and its propensity to mimic more common abdominal conditions and allergic reactions...
2018: Case Reports in Hematology
Daniel Isacson, Karl Andreasson, Maziar Nikberg, Kenneth Smedh, Abbas Chabok
PURPOSE: Outpatient management without antibiotics has been shown to be safe for selected patients diagnosed with acute uncomplicated diverticulitis (AUD). The aim of this study was to evaluate the impact on admissions, complication rates and health-care costs of the policy of outpatient treatment without using antibiotics. METHODS: The medical records of all patients diagnosed with AUD in the year before (2011) and after (2014) the implementation of outpatient management without antibiotics in Västmanland County were reviewed...
March 15, 2018: Scandinavian Journal of Gastroenterology
Matthew M Fleming, Fangfang Liu, Yawei Zhang, Kevin Y Pei
BACKGROUND: The Model for End-Stage Liver Disease (MELD) score and ascites correlate with surgical morbidity and mortality. However, the MELD score does not account for ascites. We sought to evaluate whether the MELD score accurately risk stratifies patients with ascites. METHODS: We analyzed the American College of Surgeons National Surgical Quality Improvement Program (2005-2014) to examine the risk-adjusted morbidity and mortality of cirrhotic patients with and without ascites undergoing colectomy for diverticulitis...
March 14, 2018: World Journal of Surgery
Maximilian Sohn, I Iesalnieks, A Agha, P Steiner, A Hochrein, J Pratschke, P Ritschl, F Aigner
PURPOSE: Optimal surgical management of perforated diverticulitis of the sigmoid colon has yet to be clearly defined. The purpose of this study was to evaluate efficacy of a "Damage Control Strategy" (DCS). MATERIALS AND METHODS: Patients with perforated diverticulitis of the sigmoid colon complicated by generalized peritonitis (Hinchey III and IV) surgically treated according to a damage control strategy between May 2011 and February 2017 were enrolled in the present multicenter retrospective cohort study...
March 14, 2018: World Journal of Surgery
Felix Benjamin Warwas, Berthold Schneider
PURPOSE: This study set out to compare the in-hospital outcomes of early elective and elective laparoscopic sigmoidectomy due to diverticulitis. METHODS: We examined the data for 378 diverticulitis patients who received an elective laparoscopic sigmoid resection between 2008 and 2012. We divided the patients into two groups: elective (group A, n = 278) and early elective (group B, n = 100). Patients in group A received surgery during the inflammation-free interval, and those in group B immediately after treating the attack with IV antibiotics for a mean period of 8 days (IQR = 3)...
March 13, 2018: International Journal of Colorectal Disease
M A Sohn, A Agha, P Steiner, A Hochrein, M Komm, R Ruppert, P Ritschl, F Aigner, I Iesalnieks
PURPOSE: Damage control strategy (DCS) is a two-staged procedure for the treatment of perforated diverticular disease complicated by generalized peritonitis. The aim of this retrospective multicenter cohort study was to evaluate the prognostic impact of an ongoing peritonitis at the time of second surgery. METHODS: Consecutive patients who underwent DCS for perforated diverticular disease of the sigmoid colon with generalized peritonitis at four surgical centers were included...
March 13, 2018: International Journal of Colorectal Disease
Motohiro Tamiya, Hidekazu Suzuki, Takayuki Shiroyama, Ayako Tanaka, Naoko Morishita, Norio Okamoto, Kenichi Sakai, Hironori Shigeoka, Kunimitsu Kawahara, Tomonori Hirashima
Background Bevacizumab (Bev) is generally well-tolerated, and Bev-associated intestinal perforation (BAP) is a rare albeit serious side effect in cases of non-small cell lung cancer (NSCLC). Therefore, the present study aimed to identify clinical predictors of BAP to help predict and manage the development of life-threatening intestinal complications among patients receiving Bev. Methods This retrospective study evaluated demographic, clinical, and treatment factors for patients with NSCLC who were treated with Bev between February 2010 and August 2015 at our center...
March 14, 2018: Investigational New Drugs
J Reibetanz, C T Germer
No abstract text is available yet for this article.
March 13, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Taeyoung Yoo, Keun Ho Yang, Jungbin Kim, Inseok Park, Hyunjin Cho, Geumhee Gwak, Byung Noe Bae, Ki Hwan Kim
Purpose: The aim of this study is to determine the predictable factors that affect the clinical course, especially the hospital stay, the operation performed, and to determine factors that will be helpful in deciding whether in-hospital or outpatient treatment is appropriate. Methods: We retrospectively collected medical data for patients who had been diagnosed with acute diverticulitis at Inje University Sanggye Paik Hospital between January and December 2016. In total, 117 patients were enrolled in this study...
February 2018: Annals of Coloproctology
Matthias Christian Reichert, Juozas Kupcinskas, Marcin Krawczyk, Christoph Jüngst, Markus Casper, Frank Grünhage, Beate Appenrodt, Vincent Zimmer, Susanne Nicole Weber, Algimantas Tamelis, Jaune Ieva Lukosiene, Neringa Pauziene, Gediminas Kiudelis, Laimas Jonaitis, Christoph Schramm, Tobias Goeser, Antje Schulz, Maciej Malinowski, Matthias Glanemann, Limas Kupcinskas, Frank Lammert
BACKGROUND: Colonic diverticulosis is one of the most common gastroenterological disorders. Although diverticulosis is typically benign, many individuals develop diverticulitis or other aspects of diverticular disease. Diverticulosis is thought to stem from a complex interaction of environmental, dietary, and genetic factors; however, the contributing genetic factors remain unknown. OBJECTIVE: The aim of our present study was to determine the role of genetic variants within genes encoding for collagens of the connective tissue in diverticulosis...
March 12, 2018: Diseases of the Colon and Rectum
Benito Velayos, L Del Olmo, L Merino, M Valsero, J M González
INTRODUCTION: The development of novel mechanical endoscopic closure systems allows now the management of some gastrointestinal fistula types in a minimally invasive way. However, the correct location of the fistulous tract is essential to achieve successful endoscopic closure. CASE REPORT: A 69-year-old woman with high risk for surgery presented with recurrent cystitis, pneumaturia, and enteruria 2 months after medical-treated diverticulitis. Computerized tomography demonstrated colovesical fistula but colonoscopy could not locate the fistulous opening...
March 12, 2018: International Journal of Colorectal Disease
Nicholas Yock Teck Soh, Nan Zun Teo, Carrie Jen Hsi Tan, Shivani Rajaraman, Marianne Tsang, Calvin Jian Ming Ong, Ramesh Wijaya
BACKGROUND: It is unclear if location of disease matters in perforated diverticulitis. Management guidelines for perforated diverticulitis currently do not make a distinction between right perforated diverticulitis (RPD) and left perforated diverticulitis (LPD). We aim to compare disease presentation and management outcomes between RPD and LPD. METHODS: This was a 10-year retrospective comparative cohort study of 99 patients with acute perforated diverticulitis between 2004 and 2013 in a single institution...
March 12, 2018: International Journal of Colorectal Disease
S T van Dijk, K Bos, M G J de Boer, W A Draaisma, W A van Enst, R J F Felt, B R Klarenbeek, J A Otte, J B C M Puylaert, A A W van Geloven, M A Boermeester
BACKGROUND: The shift from routine antibiotics towards omitting antibiotics for uncomplicated acute diverticulitis opens up the possibility for outpatient instead of inpatient treatment, potentially reducing the burden of one of the most common gastrointestinal diseases in the Western world. PURPOSE: Assessing the safety and cost savings of outpatient treatment in acute colonic diverticulitis. METHODS: PubMed and EMBASE were searched for studies on outpatient treatment of colonic diverticulitis, confirmed with computed tomography or ultrasound...
March 12, 2018: International Journal of Colorectal Disease
José Vicente Roig, Antonio Salvador, Matteo Frasson, Lucas García-Mayor, Javier Espinosa, Vicente Roselló, Juan Hernandis, María Dolores Ruiz-Carmona, Natalia Uribe, Rafael García-Calvo, Juan Carlos Bernal, Juan García-Armengol, Eduardo García-Granero
INTRODUCTION THE AIM: was to analyse the stoma reversal rate after surgery for complicated acute diverticulitis (CAD), and more specifically the end-stoma-reversal, as well as the delay, feasibility, complications and risk factors for stoma maintenance. METHODS: A multicentre retrospective study of patients who had undergone urgent surgery for CAD with stoma formation in ten hospitals during a period of 6 years. The frequency of reversal over time and the factors affecting the decision for reversal were analysed...
March 9, 2018: Cirugía Española
Yoshitaka Tomoda, Satoshi Kagawa, Nobuhiro Nakatake, Kazutoyo Tanaka
No abstract text is available yet for this article.
March 9, 2018: Internal Medicine
Lino Polese, Alice Bressan, Edoardo Savarino, Massimo Vecchiato, Angelo Turoldo, Annachiara Frigo, Giacomo Carlo Sturniolo, Nicolò De Manzini, Roberto Petri, Stefano Merigliano
PURPOSE: The study aimed to evaluate the QoL in patients who underwent elective surgery for uncomplicated diverticulitis using a recently developed diverticulitis quality of life questionnaire (DV-QoL). METHODS: All consecutive patients who underwent surgery for uncomplicated diverticulitis or who were hospitalized and treated conservatively for acute uncomplicated diverticulitis episodes in three referral centers, in a 5-year period, were included in the study...
March 10, 2018: International Journal of Colorectal Disease
Rao Muhammad Asaf Khan, Baqar Ali, Shahin Hajibandeh, Shahab Hajibandeh
OBJECTIVES: To investigate the effect of mesalazine on recurrence of diverticulitis in patients with symptomatic uncomplicated diverticular disease (SUDD). METHODS: We performed a systematic review and conducted a search of electronic information sources to identify all randomised controlled trials (RCTs) investigating the effect of mesalazine on the recurrence of diverticulitis in patients with SUDD. We used the Cochrane tool to assess the quality of included studies...
March 9, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Rasmus Gregersen, Kristoffer Andresen, Jakob Burcharth, Hans-Christian Pommergaard, Jacob Rosenberg
PURPOSE: The study aimed to investigate long-term mortality, recurrence, and death related to recurrence for patients admitted with acute diverticulitis with abscess formation (Hinchey stage Ib-II). METHODS: The cohort was identified by linking administrative registers for all Danish citizens in years 2000-2012. Patients were identified from ICD-10 discharge codes and stratified according to treatment (antibiotics, percutaneous abscess drainage, or surgery). RESULTS: From 6,641,672 persons, 3148 patients were identified with acute diverticulitis with abscess formation...
March 6, 2018: International Journal of Colorectal Disease
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