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Acute diverticulitis

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https://www.readbyqxmd.com/read/29334144/acute-gastrointestinal-bleeding-from-appendiceal-diverticulitis-diagnosed-preoperatively-by-combined-short-interval-computed-tomography-and-colonoscopy-a-case-report
#1
Yutaro Ogawa, Naoki Asayama, Shinji Nagata
Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding1,2 . Appendiceal diverticulosis is an uncommon clinical entity, with an incidence of 0.004%-2% in surgical pathologic specimens3,4 . Appendiceal diverticulitis in symptomatic patients should be treated with early resection, because of the risk of perforation and peritonitis; the rate of perforation is higher in appendicitis (27%) with diverticulosis than in appendicitis alone (6.6%)5 . Untreated appendiceal diverticulitis can also lead to massive gastrointestinal hemorrhage and abscess formation, and has a potential role in the development of pseudomyxoma peritonei...
January 15, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29323778/antibiotics-versus-no-antibiotics-in-the-treatment-of-acute-uncomplicated-diverticulitis-a-systematic-review-and-meta-analysis
#2
REVIEW
Ashutosh Tandon, Victoria L Fretwell, Quentin M Nunes, Paul S Rooney
BACKGROUND: Acute uncomplicated diverticulitis (AUD) is common and antibiotics are the cornerstone of traditional conservative management. This approach lacks clear evidence base and studies have recently suggested that avoidance of antibiotics is a safe and efficacious way to manage AUD. The aim of this systematic review is to determine the safety and efficacy of treating AUD without antibiotics. METHODS: A systematic search of Embase, Cochrane library, MEDLINE, Science Citation Index Expanded, and ClinicalTrials...
January 11, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29302510/a-case-of-mesenteric-cyst-in-a-4-year-old-child-with-acute-abdominal-pain
#3
Jae Woong Yoon, Du Young Choi, Yeon Kyun Oh, Seung Hyun Lee, Dong Baek Gang, Seung Taek Yu
Mesenteric cysts are rare intra-abdominal lesions occurring during childhood, which were first described in 1507. Cases of mesenteric cysts have been continuously reported, but these cases were very small in number. They are often asymptomatic and incidentally found while patients are undergoing work-up or receiving treatment for other conditions such as appendicitis, small-bowel obstruction, or diverticulitis; however, patients may still have lower abdominal pain and symptoms that are frequently associated with other abdominal conditions...
December 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/29297793/colonic-diverticulosis-and-diverticular-hemorrhage-in-a-geriatric-female-orangutan-pongo-abelii
#4
Simone Vitali, Paul Eden, Karen Payne, Geoffrey Forbes
A 57-yr-old female Sumatran orangutan ( Pongo abelii) presented with signs of intermittent lethargy and inappetence, then subsequently developed profuse hemorrhagic diarrhea. Colonoscopy under anesthesia revealed diverticulosis of the descending colon, with multiple large diverticula containing fecoliths. There was no evidence of diverticulitis, but a regenerative anemia had developed following an acute diverticular bleed. The orangutan recovered with conservative therapy. Colonic diverticulosis has been reported in nonhuman primates and appears to have a similar clinical presentation to the condition as it occurs in humans...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29290892/differential-diagnoses-of-magnetic-resonance-imaging-for-suspected-acute-appendicitis-in-pregnant-patients
#5
Ji Yong Jung, Ji Ung Na, Sang Kuk Han, Pil Cho Choi, Jang Hee Lee, Dong Hyuk Shin
BACKGROUND: Accurate and timely diagnosis of acute surgical disease in pregnant patient is challenging. Although magnetic resonance imaging (MRI) is the most accurate modality to diagnose acute appendicitis in pregnant patients, it is often used as a last resort because of high cost and long scan time. We performed this study to analyze differential diagnoses of appendix MRI and to investigate if there are any blood tests that can predict surgical condition in pregnant patients. METHODS: A retrospective, cross-sectional study was conducted on 46 pregnant patients who underwent non-enhanced appendix MRI in suspicion of acute appendicitis from 2010 to 2016...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29289391/acute-diverticulitis-in-renal-transplant-patients-should-we-treat-them-differently
#6
Jeremy Sugrue, Joanna Lee, Christina Warner, Sany Thomas, Ivo Tzvetanov, Winnie Mar, Anders Mellgren, Johan Nordenstam
BACKGROUND: Current guidelines suggest that transplant patients with acute diverticulitis should be managed aggressively with early operative intervention to reduce morbidity and mortality. This study compared the treatment choices and clinical outcomes between renal transplant patients and immunocompetent patients with acute diverticulitis. METHODS: A retrospective review was performed of all patients who were admitted with acute diverticulitis between 2002 and 2015 at a single academic institution...
December 27, 2017: Surgery
https://www.readbyqxmd.com/read/29279643/meckel-s-diverticulitis-masquerading-as-acute-pancreatitis-a-diagnostic-dilemma
#7
C Danny Darlington, G Fatima Shirly Anitha
Meckel's diverticulum is a remnant of the proximal part of the vitellointestinal duct and is the most common congenital anomaly of the gastrointestinal tract. It may either remain asymptomatic or present with myriad of clinical presentations. Gastrointestinal bleeding is the most common presentation in children whereas it is intestinal obstruction in the case of adults. We report a 9-year-old boy who presented with acute onset of periumbilical pain and nonbilious vomiting. His clinical and laboratory parameters were unremarkable, except for serum amylase levels...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29204676/surgical-management-in-acute-diverticulitis-and-its-association-with-multi-detector-ct-modified-hinchey-classification-and-clinical-parameters
#8
David D B Bates, Marina Bernal Fernandez, Cecilia Ponchiardi, Michael von Plato, Joshua P Teich, Chaitan Narsule, Stephan W Anderson, Avneesh Gupta, Christina A LeBedis
PURPOSE: To assess whether CT findings, clinical parameters, and modified Hinchey classification are predictive of management outcomes of patients with acute diverticulitis. MATERIALS AND METHODS: Data were accrued between January 2014 and December 2015. A total of 301 adult subjects were identified from radiology reports, of which six who did not met the inclusion criteria were excluded, thus yielding 295 subjects. Subjects were 43.1% (n = 127) male and 56.9% female (n = 168), with mean age 51...
December 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29202817/use-of-cardiovascular-magnetic-resonance-in-the-evaluation-of-a-giant-right-atrial-appendage-aneurysm-a-case-report-and-review-of-the-literature
#9
Lojan Sivakumaran, Karl Sayegh, Emile Mehanna, Frank W Sanchez, Jonathan Fields, Ricardo Cury
BACKGROUND: Right atrial appendage aneurysms are rare entities that may have significant clinical consequences. When co-existing with atrial fibrillation, patients are at risk of developing pulmonary or paradoxical systemic emboli. CASE PRESENTATION: An elderly patient presented to medical attention with symptoms of acute diverticulitis. On abdominal computed tomography, a massively enlarged right atrial appendage aneurysm was discovered incidentally. The aneurysm caused marked compression of the right ventricle and contained an area of hypoenhancement concerning for an intraluminal thrombus...
December 4, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29185246/is-there-a-role-for-procalcitonin-in-differentiating-uncomplicated-and-complicated-diverticulitis-in-order-to-reduce-antibiotic-therapy-a-prospective-diagnostic-cohort-study
#10
Victor Jeger, Roxana Pop, Farschad Forudastan, Jean Pierre Barras, Markus Zuber, Rein Jan Piso
AIMS OF THE STUDY: While studies show that antibiotic treatment for uncomplicated diverticulitis seems to have no benefit, most experts advocate antimicrobial therapy for complicated diverticulitis. However, even for uncomplicated diverticulitis, most clinicians are very reluctant to withhold antibiotics. Biomarkers could help to guide antibiotic therapy as this approach has been shown to be effective for acute respiratory infections. In this diagnostic cohort study we evaluated whether procalcitonin could be a biomarker to distinguish complicated from uncomplicated cases of diverticulitis...
November 29, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29178125/laparoscopic-versus-open-resection-for-sigmoid-diverticulitis
#11
REVIEW
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
https://www.readbyqxmd.com/read/29133083/jejunal-diverticulitis-review-and-treatment-algorithm
#12
Houssem Harbi, Nizar Kardoun, Sami Fendri, Nouha Dammak, Nozha Toumi, Ahmed Guirat, Rafik Mzali
Diverticulitis is much less common in the jejunum than in colonic diverticula probably because of diverticulum larger size, better intra-luminal flow and relatively sterile jejunal content. Complications of jejunal diverticulitis are acute intestinal obstruction, diverticular bleeding and mainly perforation with mesenteric abscess, localized or generalized peritonitis. The Multi-detector row computed tomography is now the best diagnostic imaging for small bowel diverticulitis as well as its complications. Magnetic resonance enterography is also quite useful but it is still impractical to resort to such an imaging in an abdominal emergency...
November 10, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29123444/imaging-findings-of-the-unusual-presentations-associations-and-clinical-mimics-of-acute-appendicitis
#13
REVIEW
Mustafa Kemal Demir, Yildiray Savas, Yavuz Furuncuoglu, Tarik Cevher, Serdar Demiral, Babek Tabandeh, Melisa Aslan
There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome...
October 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/29118874/pharmacobezoar-an-unusual-cause-of-large-bowel-obstruction
#14
Rishitha Yelisetti, Areig Awad, Bushra Ambreen, Ritika Zijoo, Sara Wallach
Large bowel obstruction (LBO) is an abdominal emergency with high morbidity and mortality rates if left untreated. LBO is four to five times less frequent than small bowel obstruction (SBO) and the causes of LBO and SBO differ substantially. Colonic malignancy remains the most common cause of LBO (> 60%). Additional causes of LBO include entities such as diverticulitis, colonic volvulus, and adhesion. Herein we present a case of acute LBO caused by pharmacobezoar.
October 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29115651/computed-tomography-findings-of-primary-epiploic-appendagitis-as-an-easily-misdiagnosed-entity-case-series-and-review-of-literature
#15
Rabia Ergelen, Ruslan Asadov, Burcu Özdemir, Derya Tureli, Baha Tolga Demirbaş, Davut Tuney
BACKGROUND: Primer epiploic appendagitis (PEA) is an uncommon condition. METHODS: We retrospectively reviewed the clinical records and computed tomography (CT) findings of 45 patients with PEA. RESULTS: On the basis of physical examination and pain localization, presumptive clinical diagnosis was acute appendicitis (n=13), acute cholecystitis (n=2), acute diverticulitis (n=19), renal colic (n=7) and ovarian pathology (n=4). CONCLUSION: Although it has no characteristic clinical and laboratory features, CT is the best modality for accurate diagnosis of PEA...
November 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29101918/diverticular-disease-practice-points
#16
William McSweeney, Havish Srinath
BACKGROUND: Diverticular disease and its spectrum of complications are increasingly encountered in the Australian population. Accurate management of patients before and after an acute episode entails extension beyond the acute event to include dietary advice and colonoscopy. OBJECTIVE: The objectives of this article are to evaluate the literature regarding dietary factors and diverticular disease, routine colonoscopy and antibiotic treatment in acute diverticulitis, to enable primary care physicians to manage patients and provide sound advice after hospital admission...
November 2017: Australian Family Physician
https://www.readbyqxmd.com/read/29098095/medical-approach-to-right-colon-diverticulitis-with-perforation
#17
James Espinosa, Rahul Sharma, Alan Lucerna, Doug Stranges
We report a case of a 71-year-old female who presented with right lower quadrant (RLQ) abdominal pain and was diagnosed on CT scan with right-sided diverticulitis with perforation. She was admitted under the surgical service after consultation and received intravenous fluids, intravenous antibiotics, and pain medications as needed. The patient was discharged 2 days after admission in stable condition with follow-up with gastroenterology. The differential diagnosis of right lower quadrant abdominal pain is vast...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29093588/-complicated-jejunoileal-diverticular-disease-a-12-cases-serie-and-literature-review
#18
Aylhin Joana López Marcano, José Manuel Ramia, Roberto De la Plaza Llamas, Soledad Alonso, Johnny David Gonzales Aguilar, Andree Wolfgang Kühnhardt Barrantes
OBJECTIVE: To perform a retrospective analysis of a series of complicated JID (jejunoileal diverticulitis) cases surgically treated in our service during the period from 2002 to 2015. MATERIALS AND METHODS: We treated 12 cases of jejunoileal complicated diverticulosis. 7 women and 5 men. The mean age was 76 years. The clinical presentation in all cases was acute abdominal pain, one with gastrointestinal bleeding. All cases had leukocytosis, neutrophilia and increased acute phase reactants...
July 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/29092714/pylephlebitis-presenting-as-spontaneous-coronary-sinus-thrombosis-a-case-report
#19
Michael A Hart, Mengistu A Simegn
BACKGROUND: Coronary sinus thrombosis is a rare phenomenon. When identified, it most often is a complication of infective endocarditis or procedural intervention. We present an unusual and unreported case of spontaneous coronary sinus thrombosis as embolic sequela of an intra-abdominal infectious process. CASE PRESENTATION: We report a case of a 61-year-old white woman with a history of end-stage renal disease on hemodialysis, paroxysmal atrial fibrillation not on long-term systemic anticoagulation, and history of recurrent diverticulitis that presented with acute onset abdominal pain and nausea...
November 2, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29091955/delta-neutrophil-index-as-a-promising-prognostic-marker-of-emergent-surgical-intervention-for-acute-diverticulitis-in-the-emergency-department
#20
Hee Seung Kang, Yong Sung Cha, Kyung Hye Park, Sung Oh Hwang
BACKGROUND: Early identification of patients with acute diverticulitis who require emergent surgical intervention in the emergency department (ED) is important to the physician. Although computed tomography (CT) has an important role in evaluating the severity of diverticulitis, its findings alone may not predict the need for emergent surgical intervention in all patients with acute diverticulitis in the ED. Serum inflammation markers may help to differentiate severity of acute diverticulitis and predict the need for surgical intervention in clinical practice...
2017: PloS One
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