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Query: UMLS:C0000727 (acute abdomen)
3,084 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diverticulosis of the colon is a very frequent pathology in the western word and is characterised by a high percentage of dangerous complications (10-25%). The most accurate method of staging diverticular disease is by CT scan. The aim of our study was to evaluate the sensitivity of ultrasonography in the evaluation and management of diverticular disease of the colon. We studied 51 patients: the parameters used to assess complicated diverticulosis of the colon were: 1) wall thickness; 2) presence of fluid collections and pericolic abscesses; 3) free liquid collections in the peritoneal cavity; 4) subdiaphragmatic free air; 5) presence of fistula tracts. Ultrasonography showed 66% sensitivity in the assessment of wall thickness and in detecting the presence of diverticula. The sensitivity rate was 100% in the detection of abscess complications, pericolic collections, free air and fistula tracts. False-negatives (5 patients) were all recorded in Hinchey stage I. The overall sensitivity amounted to 91%. In our experience the method is a first level examination in the approach to patients suffering from diverticular disease of the colon and presents high sensitivity and diagnostic accuracy. The method, in expert hands, is suggested as a first step in the clinical-diagnostic approach to patients suffering from acute abdomen due to diverticulitis of the colon.
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PMID:[Role of ultrasonographic imaging in the surgical management of acute diverticulitis of the colon]. 1194 14

We report a case of acute, small bowel obstruction secondary to intussusception caused by an enterolith from a jejunal diverticulum, in an elderly female with a history of chronic, intermittent abdominal pain. Diagnostic work-up of the patient included a computed tomographic (CT) scan which demonstrated the intussusception, but not the enterolith, which was characteristically radiolucent. A laparotomy was performed and the enterolith was found and delivered. A fistula between the gallbladder and small bowel was sought, but not found. Multiple diverticulae were found throughout the small bowel. Although small bowel diverticulosis is rare, it should be considered in the differential diagnosis of the acute abdomen and chronic abdominal pain, especially in those with known colonic diverticulosis, in whom this condition is more common.
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PMID:Intussusception of the small bowel secondary to an enterolith from a jejunal diverticulum. 2178 81

Perforated sigmoid diverticulitis, a complication of colonic diverticulosis commonly associated with autosomal dominant polycystic kidney disease (ADPKD), can be life-threatening in allogeneic kidney transplant recipients in the postoperative period. Immunosuppressive medications not only place the patient at risk for intestinal perforation, but also mask classic clinical symptoms and signs of acute abdomen, and subsequently lead to delayed diagnosis and treatment. We report a case of an ADPKD patient post kidney transplantation presenting with nausea, vomiting, and abdominal pain without signs of peritonitis. Chest x-ray revealed free air under the diaphragm consistent with intestinal perforation. Post kidney transplant recipients with ADPKD presenting with abdominal pain should prompt a search for possible perforated colonic diverticulitis in order to diagnose and treat this life-threatening condition early.
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PMID:Atypical presentation of perforated sigmoid diverticulitis in a kidney transplant recipient with autosomal dominant polycystic kidney disease. 2390 92

Giant colonic diverticulum (GCD) is a rare complication of colonic diverticulosis. A small number of cases has been reported in the literature. Patients with GCD have often few non-specific symptoms. Unfortunately, severe complications exist and may lead to surgical acute abdomen. Therefore, this complication of the diverticular disease must be known and properly treated. There is no gold standard diagnostic test, but an air-fluid or air-filled, rounded, pseudocystic image in relation with the colonic wall in a patient with colonic diverticula should suggest this diagnosis to the clinician. We report two cases of a 70-year-old male patient and a 44-year-old female patient having a giant sigmoid diverticulum. The treatment of choice of an uncomplicated GCD is an elective colonic resection, including the giant -diverticulum, with primary anastomosis ; while in case of complicated GCD (peritonitis, abscess or complex fistula), a two-stage resection should be considered.
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PMID:Sigmoid Resection with Primary Anastomosis for Uncomplicated Giant Colonic Diverticulum : a Report of two Cases. 2602 25

In this review, we discuss the clinical and radiologic findings of small bowel diverticulosis, which is infrequently encountered during practice and far less common than colonic diverticulosis. Small bowel diverticulosis can present with a range of emergent symptomatic complications including diverticulitis, perforation, or hemorrhage. Here, we focus on the clinical features, pathogenesis, radiologic findings, and treatment of small bowel diverticulitis. Although not routinely considered in the differential diagnosis of an acute abdomen, prospective radiologic diagnosis of small bowel diverticulitis is important and can lead to conservative treatment thus preventing unnecessary exploratory laparotomy.
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PMID:Small bowel diverticulitis: an imaging review of an uncommon entity. 2781 48