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Acute diverticulitis

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https://www.readbyqxmd.com/read/28089941/laparoscopic-peritoneal-lavage-or-surgical-resection-for-acute-perforated-sigmoid-diverticulitis-a-systematic-review-and-meta-analysis
#1
REVIEW
Faisal M Shaikh, Peter M Stewart, Stewart R Walsh, R Justin Davies
BACKGROUND: Laparoscopic peritoneal lavage (LPL) has been proposed as an alternative, less invasive technique in the treatment of acute perforated sigmoid diverticulitis (APSD). The aim of this meta-analysis is to compare the effectiveness of LPL versus surgical resection (SR) in terms of morbidity and mortality in the management of APSD. METHODS: A comprehensive search was conducted for randomised controlled trials (RCTs) comparing LPL versus SR in the treatment of APSD...
January 9, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28064243/meckel-s-diverticulitis-a-rare-entity-of-meckel-s-diverticulum
#2
Chee S Wong, Leanne Dupley, Haren N Varia, Darek Golka, Thu Linn
Meckel's diverticulum is the most common congenital abnormality of the small intestine that results from incomplete closure of the vitelline (omphalo-mesenteric) duct. This true diverticulum, ~2 ft from the ileocecal valve commonly found on the anti-mesenteric border of the ileum, is benign and majority asymptomatic. Diagnosis challenges arise when it became inflamed or presented in following ways, for example, haemorrhage (caused by ectopic pepsin-and hydrochloric acid-secreting gastric mucosa), intestinal obstruction (secondary to intussusception or volvulus) or the presence of diverticulum in the hernia sac (Littre's hernia)...
January 6, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28054168/minimally-invasive-surgery-for-complicated-diverticulitis
#3
Najjia N Mahmoud, Elijah W Riddle
Recent guidelines recommend an individualized approach to recurrent uncomplicated diverticulitis, reflecting research showing that non-operative treatment is safe. Thus, the majority of operations for diverticulitis in the future may be for complicated indications. A laparoscopic approach may be used for both acute and chronic complicated diverticulitis in appropriate patients, as described in the American and European guidelines. However, a safe approach to minimally invasive surgery requires recognition when conditions deteriorate or are not suited to laparoscopy as well as knowledge of a variety of technical maneuvers that elucidate difficult anatomy and facilitate resection...
January 4, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28035461/is-early-colonoscopy-after-ct-diagnosed-diverticulitis-still-necessary
#4
Thomas Surya Suhardja, Shana Norhadi, Edward Zhenyu Seah, Stephen Rodgers-Wilson
PURPOSE: WHO GLOBOCAN 2012 data showed that Australia and New Zealand have the highest incidence rates of colorectal cancer in the world (Ferlay et al. 1). Current guidelines recommend that patients admitted for an episode of acute diverticulitis require an early follow-up colonoscopy to rule out colorectal malignancy as reported by Fozard et al. (Colorectal Dis 13:1-11, 2011). Recent studies however have indicated that this may not be warranted (Brar et al. Dis Colon rectum 56:1259-1264, 2013)...
December 29, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28024211/conservative-approach-to-hepatic-portal-venous-gas-a-case-report
#5
G C Ginesu, M Barmina, M L Cossu, C F Feo, A Fancellu, F Addis, A Porcu
INTRODUCTION: Hepatic Portal Venous Gas (HPVG), a rare condition in which gas accumulates in the portal venous circulation, is often associated with a significant underlying pathology, such as Crohn's disease, ulcerative colitis, diverticulitis, pancreatitis, sepsis, intra-abdominal abscess, endoscopic procedures, mesenteric ischemia, abdominal trauma. PRESENTATION OF CASE: Here we report a case of HPVG in an 82-year-old patient who underwent a left colectomy for stenosing tumor of the descending colon...
December 11, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28012340/role-of-computed-tomography-in-predicting-prognosis-of-hepatic-portal-venous-gas
#6
Makram Moussa, Inès Marzouk, Kais Abdelmoula, Amira Manamani, Nadida Dali, Leila Charrada Ben Farhat, Lotfi Hendaoui
BACKGROUND: The aim of this study was to report through 13 cases the particularities of abdominal computed tomography (CT) aspects of hepatic portal venous gas (HPVG) and its correlation with patient prognosis. METHODS: We analyzed abundance of HPVG and its association with pneumatosis intestinalis (PI) in correlation with fatal outcome using chi-square tests. RESULTS: Etiologies were mesenteric infarction (n=5), sigmoid diverticulitis (n= 1), septic shock (n=1), postoperative peritonitis (n=1), acute pancreatitis (n=1), iatrogenic cause (n=3) and idiopathic after a laparotomy (n=1)...
December 2, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27990793/therapeutic-management-of-acute-uncomplicated-diverticulitis
#7
Y Claire Fan, Anne F Peery
Acute diverticulitis is a painful disease of the colon characterized by peridiverticular inflammation and/or infection. The spectrum of acute diverticulitis ranges from isolated peridiverticular inflammation all the way to free perforation with purulent or feculent peritonitis. Among gastrointestinal disorders, acute diverticulitis is one of the most common diagnoses in the ambulatory setting and principal hospital discharge diagnoses. Acute diverticulitis accounts for substantial utilization of healthcare resources and is a detriment to patients' quality of life...
December 16, 2016: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27987280/abdominal-pain-learning-when-not-to-intervene
#8
Niranjan Tachamo, Bidhya Timilsina, Salik Nazir, Saroj Lohani
Epiploic appendagitis (EA) is an uncommon cause of abdominal pain. It is a benign condition but may mimic other serious causes of acute abdomen such as appendicitis, diverticulitis, and gynecological emergency in severe cases. Knowledge of this condition in the differential diagnosis of abdominal pain can save unnecessary hospital admission, antibiotics, and surgery. In this article, we present the case of a 43-year-old female who presented to our hospital with a 2-day history of right lower quadrant abdominal pain and diarrhea...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27974987/a-case-report-of-acute-diverticulitis-in-pseudodiverticulosis-after-hemorpex-system%C3%A2-procedure
#9
Tommaso Testa, Federico Costanzo
Introduction. In the last years many mini-invasive approaches were developed in order to reduce postoperative pain and complication after haemorrhoid surgery: one of these alternatives is represented by Hemorpex System, a relatively young technique that combines transanal dearterialization with mucopexy through a dedicated proctoscope. Case Presentation. A 78-year-old male patient was admitted to the Emergency Department for acute urinary retention and elevated temperature. Hemorpex procedure was performed 4 years before...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27973464/pathogenesis-of-diverticulosis-and-diverticular-disease
#10
Marjorie M Walker, Angela K Harris
Diverticulosis is defined by the presence of diverticula due to herniation of mucosa and muscularis mucosa through the muscularis propria at sites of vascular penetration in the colon and is asymptomatic in the vast majority affected. There are global differences of distribution, in Western industrialised societies, the most common site is in the right colon, but in Asia left sided diverticulosis predominates. Whilst present in 17.5% of a general population and 42% of all comers at endoscopy it is seen in 71% of those aged ≥80 years...
December 14, 2016: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27973463/rationale-and-evidences-for-treatment-of-symptomatic-uncomplicated-diverticular-disease
#11
Rosario Cuomo, Martina Cargiolli, Paolo Andreozzi, Francesco P Zito, Giovanni Sarnelli
INTRODUCTION: Symptomatic uncomplicated diverticular disease (SUDD) is one of the possible clinical manifestations of diverticular disease. It is a common disorder characterized by chronic abdominal symptoms ranging from lower left abdominal pain to alteration of bowel habit, that significantly reduce quality of life of subject affected. The present article aims to review the current data for medical management of SUDD. EVIDENCE ACQUISITION: We analyzed the existing literature on the factors involved in the pathogenesis of SUDD and we highlighted the possible target for treatment...
December 14, 2016: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27957337/national-complicated-acute-diverticulitis-cads-study-a-protocol-for-a-prospective-observational-scoping-study-for-acute-diverticulitis
#12
Shafaque Shaikh
BACKGROUND: Diverticular disease is a widely prevalent disease in western society, and acute diverticulitis is a common acute surgical presentation. However, there is a lack of level 1 evidence addressing the multifaceted presentations associated with acute diverticulitis. There is also a lack of robust epidemiological data that could be used to meaningfully inform randomised controlled trials. The National CADS project aims to generate baseline data for a cohort of patients managed for clinically suspected acute diverticulitis and evaluate the impact of variability in the management approach on patient outcomes in the short (3 months) and long (2 years) term...
2016: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/27955857/-prognostic-value-of-the-presence-of-pericolic-air-bubbles-detected-by-computed-tomography-in-acute-diverticulitis
#13
Mario Antonio García-Gómez, Carlos Belmonte-Montes, Carlos Cosme-Reyes, Manuel Preben Aguirre Garcia
BACKGROUND: Diverticular disease is common in industrialized countries. Computed tomography has been used as the preferred diagnostic method; although different scales haves been described to classify the disease, none of them encompass total disease aspects and behaviour. OBJETIVE: To analyze the patients with acute diverticulitis confirmed by computed tomography at the ABC Medical Center Campus Observatorio from January 1, 2010 to December 31, 2012, in whom pericolic free air in the form of bubbles was identified by computed tomography and if this finding can be considered as a prognostic factor for the disease...
December 9, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27941344/routine-colonoscopy-after-acute-uncomplicated-diverticulitis-challenging-a-putative-indication
#14
Patrícia Andrade, Armando Ribeiro, Rosa Ramalho, Susana Lopes, Guilherme Macedo
BACKGROUND AND AIMS: Most international guidelines recommend performing a routine colonoscopy after the conservative management of acute diverticulitis, mainly to rule out a colorectal malignancy; however, data to support these recommendations are scarce and conflicting. This study is aimed at determining the rate of advanced colonic neoplasia (ACN) found by colonoscopy, and hence the need for routine colonoscopy after CT-diagnosed acute diverticulitis. METHODS: We retrospectively analyzed all patients hospitalized for acute diverticulitis between July 2008 and June 2013...
December 10, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27941316/the-utility-of-neutrophil-to-lymphocyte-ratio-as-a-predictor-of-intervention-in-acute-diverticulitis
#15
Ian S Reynolds, Roisin M Heaney, Waqar Khan, Iqbal Z Khan, Ronan Waldron, Kevin Barry
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) is a novel biomarker that has been recently studied in diverticulitis. The primary aim of this study was to assess the accuracy of NLR in predicting which patients had complicated diverticulitis and which patients required a radiological or surgical intervention. The accuracy of NLR was compared to C-reactive protein (CRP), white blood cell (WBC) count, neutrophil count and white cell to lymphocyte ratio (WLR). METHODS: Details of all patients admitted with acute diverticulitis over an 18-month period were collected prospectively...
December 10, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27885390/ct-angiography-in-the-setting-of-suspected-acute-mesenteric-ischemia-prevalence-of-ischemic-and-alternative-diagnoses
#16
Frank Oliver Henes, Perry J Pickhardt, Andrzej Herzyk, Scott J Lee, Utaroh Motosugi, Thorsten Derlin, Meghan G Lubner, Gerhard Adam, Gerhard Schön, Peter Bannas
PURPOSE: The purpose of the study was to determine the prevalence of ischemic and alternative diagnoses and the diagnostic accuracy of CT angiography (CTA) in the setting of suspected acute mesenteric ischemia (AMI). MATERIAL AND METHODS: We included 959 patients undergoing CTA for the evaluation of suspected AMI. The final clinical diagnosis was used to determine the prevalence of ischemic and alternative diagnoses and to calculate the diagnostic accuracy of CTA...
November 24, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27879143/-perforated-jejunal-diverticulitis
#17
Z Básti, P Brunčák
Jejunal diverticulosis is a rare disorder and the course of the disease is mostly asymptomatic. Surgical treatment is generally needed in case of complications in the acute phase of the disease, when the disease symptoms most commonly include bleeding and perforation. Jejunum is difficult to examine using the common visualization methods and endoscopic methods. The authors present case reports of a 92 years old female patient and a 66 years old male patient operated for perforated jejunal diverticles.Key words: acute abdomen jejunal diverticulitis perforation...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/27878550/diverticulitis-a-comprehensive-review-with-usual-and-unusual-complications
#18
REVIEW
Mehmet Ruhi Onur, Erhan Akpinar, Ali Devrim Karaosmanoglu, Cavid Isayev, Musturay Karcaaltincaba
: Diverticulitis is characterized by inflammation of the outpouchings of the bowel wall. Imaging findings of diverticulitis include edematous thickening of the bowel wall with inflammatory changes within the adjacent mesenteric fat. Uncomplicated diverticulitis can be treated conservatively; however, complicated diverticulitis may not be responsive to medical treatment and life-threatening conditions may occur. In this review, we aimed to illustrate the ultrasonography (US) and computed tomography (CT) features of diverticulitis and its complications including perforation, phlegmon, abscess, ascending septic thrombophlebitis (phylephlebitis), bleeding, intestinal obstruction, and fistula...
November 22, 2016: Insights Into Imaging
https://www.readbyqxmd.com/read/27865426/surgical-treatment-of-acute-diverticulitis-a-retrospective-multicentre-study
#19
José Vicente Roig, Antonio Salvador, Matteo Frasson, Míriam Cantos, Celia Villodre, Zutoia Balciscueta, Rafael García-Calvo, Javier Aguiló, Juan Hernandis, Rodolfo Rodríguez, Francisco Landete, Eduardo García-Granero
INTRODUCTION: To analyze short and medium-term results of different surgical techniques in the treatment of complicated acute diverticulitis (CAD). METHODS: Multicentre retrospective study including patients operated on as surgical emergency or deferred-urgency with the diagnosis of CAD. RESULTS: A series of 385 patients: 218 men and 167 women, mean age 64.4±15.6 years, operated on in 10 hospitals were included. The median (25(th)-75(th) percentile) time from symptoms to surgery was 48 (24-72) h, being peritonitis the main surgical indication in a 66% of cases...
December 2016: Cirugía Española
https://www.readbyqxmd.com/read/27834014/ipod-study-management-of-acute-left-colonic-diverticulitis-in-italian-surgical-departments
#20
Massimo Sartelli, Gian Andrea Binda, Francesco Brandara, Andrea Borasi, Francesco Feroci, Salvatore Vadalà, Francesco M Labricciosa, Arianna Birindelli, Gianluigi Luridiana, Federico Coccolini, Salomone Di Saverio, Fausto Catena, Luca Ansaloni, Fabio Cesare Campanile, Ferdinando Agresta, Diego Piazza
BACKGROUND: In recent years, the emergency management of acute left colonic diverticulitis (ALCD) has evolved dramatically despite lack of strong evidence. As a consequence, management strategies are frequently guided by surgeon's personal preference, rather than by scientific evidence. The primary aim of IPOD study (Italian Prospective Observational Diverticulitis study) is to describe both the diagnostic and treatment profiles of patients with ALCD in the Italian surgical departments...
November 10, 2016: World Journal of Surgery
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