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Acute diverticulitis

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
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
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
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
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
Toufik A Tabbara, Omar Y Alassaf, Mujtaba C Kaouas
INTRODUCTION: Acute epiploic appendagitis is a relatively rare disease that mimics a varied number of diseases. PRESENTATION OF CASE: In this paper we report a 24-year-old male who presented with epiploic appendagitis that might have been misdiagnosed by physicians due to its equivocal presentation imitating more common acute abdominal conditions like acute appendicitis or acute diverticulitis depending on the site of the inflamed appendage. DISCUSSION: The clinical presentation, investigations findings and both conservative and surgical interventions of the patient are mentioned within the report...
February 23, 2018: International Journal of Surgery Case Reports
Chanakyaram A Reddy, Stacy B Menees
No abstract text is available yet for this article.
March 1, 2018: American Journal of Gastroenterology
Jakub Kenig, Kinga Mastalerz, Katarzyna Lukasiewicz, Maria Mitus-Kenig, Urszula Skorus
The Surgical Apgar Score (SAS) is a simple and rapid scoring system predicting postoperative mortality and morbidity. However, it remains unknown whether it might be useful in fit and frail older patients undergoing abdominal emergency surgery. METHODS: Consecutive patients ≥65 years, needing emergency abdominal surgery were enrolled in this prospective study. Additionally to the SAS, the G8 screening score was used to determine the frailty status. The logistic regression analysis was conducted investigating the association between the scores and 30-day postoperative outcomes...
February 10, 2018: Archives of Gerontology and Geriatrics
Valentin Mocanu, Jerry T Dang, Noah Switzer, Iran Tavakoli, Chunhong Tian, Christopher de Gara, Daniel W Birch, Shahzeer Karmali
BACKGROUND: Antibiotics use in acute uncomplicated diverticulitis (AUD) remains debated despite recent studies suggesting no difference in outcomes for patients treated without antibiotics. DATA SOURCES: Systematic review and meta-analysis were performed to determine the role of antibiotics in managing AUD. Literature search was conducted using Medline, EMBASE, Scopus, the Cochrane Library, and Web of Science databases from 1946 to June 2017. Eight studies with 2469 patients were included for review...
February 2, 2018: American Journal of Surgery
Francesco Saverio Mennini, Paolo Sciattella, Andrea Marcellusi, Bernardo Toraldo, Maurizio Koch
INTRODUCTION: Diverticular disease (DD) represent a wide variety of conditions associated with the presence of diverticula in the colon. The most serious form is an acute episode of diverticulitis which can lead to hospitalization and surgery with various types of consequences. The main aim of this study was to evaluate, from both cross-sectional and longitudinal perspective, the economic burden of diverticulitis in the real practice. METHOD: A deterministic linkage was performed at individual user level between the different administrative sources of the Marche Region through anonymised ID number for a period of analysis between 1 January 2008 and 31 December 2014...
January 2018: Recenti Progressi in Medicina
Max Ditzel, Sandra Vennix, Anand G Menon, Paul C M Verbeek, Willem A Bemelman, Johan F Lange
BACKGROUND: Diverticulitis can lead to localized or generalized peritonitis and consequently induce abdominal adhesion formation. If adhesions would lead to abdominal complaints, it might be expected that these would be more prominent after operation for perforated diverticulitis with peritonitis than after elective sigmoid resection. AIMS: The primary outcome of the study was the incidence of abdominal complaints in the long-term after acute and elective surgery for diverticulitis...
February 9, 2018: Digestive Surgery
Charlotte El-Sayed, Simon Radley, Jemma Mytton, Felicity Evison, Stephen T Ward
BACKGROUND: Diverticular disease accounts for significant morbidity and mortality and may take the form of recurrent episodes of acute diverticulitis. The role of elective surgery is not clearly defined. OBJECTIVE: This study aimed to define the rate of hospital admission for recurrent acute diverticulitis and risk factors associated with recurrence and surgery. DESIGN: This is a retrospective population-based cohort study. SETTINGS: National Health Service hospital admissions for acute diverticulitis in England between April 2006 and March 2011 were reviewed...
March 2018: Diseases of the Colon and Rectum
Deborah L Ellison
Diverticular disease accounts for approximately 300,000 hospitalizations per year in the United States, resulting in 1.5 million days of inpatient care. Diverticulitis is defined as an inflammation of the diverticulum, which can be asymptomatic or symptomatic. This disease is the third most common gastrointestinal illness that requires hospitalization and the leading indication for elective colon resection. Abdominal pain is the most common complaint in patients with acute diverticulitis. The pain can be described as cramping, constant, and persistent for several days...
March 2018: Critical Care Nursing Clinics of North America
Manupriya Sharma, Rashmi Kaul, Bal Chander
Enterobius vermicularis is an intestinal nematode commonly affecting children worldwide. Its transmission is by feco-oral route. Meckel's diverticulitis due to E. vermicularis infestation is an extremely rare presentation. An 11-year-old boy presented with acute abdomen. During surgery inflamed Meckel's diverticulum (M.D) was seen. Histopathology examination of specimen revealed E. vermicularis. Till date, only one case of E. vermicularis infestation of M.D is reported around five decades ago. This histopathological confirmation is extremely important as the required treatment (Mebendazole) of the infected case along with household contacts can prevent the spread of infection and may avoid surgery in known contacts...
January 2018: Journal of Laboratory Physicians
Martina Brandlhuber, Christian Genzinger, Bernhard Brandlhuber, Wieland H Sommer, Mario H Müller, Martin E Kreis
PURPOSE: It is controversial whether patients fare better with conservative or surgical treatment in certain stages of acute diverticulitis (AD), in particular when phlegmonous inflammation or covered micro- or macro-perforation are present. The aim of this study was to determine long-term quality of life (QoL) for AD patients who received either surgery or conservative treatment in different stages. METHODS: We included patients treated for AD at the University Hospital Grosshadern, Munich, Germany, between January 1, 2000, and December 31, 2010...
March 2018: International Journal of Colorectal Disease
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