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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Uncomplicated diverticular disease is usually asymptomatic. When abdominal pain or discomfort related to defecation, altered bowel habit, and flatulence occur, they are likely a result of a coexistent irritable bowel. Nonetheless, diverticula are subject to serious complications. Diverticular hemorrhage may be massive and require emergency angiography and segmental resection. Peridiverticulitis occurs when a diverticulum ruptures, perhaps because of inspissated fecal material. This occurs usually in the sigmoid, resulting in a peridiverticular abscess localized by the adjacent fat and mesentery. If the infection extends beyond this, abscess, fistula, or free perforation may occur. These complications require antibiotics, intravenous therapy, and, in the case of uncontrollable abscess or perforation, urgent surgery. Obstruction of the colon, sometimes associated with ileus, may occur and in this case one may find a carcinoma among extensive diverticular disease. Although there is insufficient evidence to justify a high-fiber diet for the general population, the notion of a low-residue diet in the management of uncomplicated diverticular disease should be laid to rest.
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PMID:Clinical picture of diverticular disease of the colon. 353 13

Diverticulosis of the colon and its clinical sequelae--diverticulitis, peridiverticulitis, and pericolitis--are typical diseases of elderly people. The main causes are weakness of the connective tissue in the colonic wall increasing with age and pathologic motility pattern of the colon due to low dietary fibre consumption. In about 20% of all people with diverticula, acute or chronic-recurrent diverticulitis develops, often with serious complications as perforation, abscess or fistula formation, obstruction, inflammatory pseudotumor and intestinal bleeding. Diagnosis is mainly based on clinical examination and barium enema (double contrast, maximal spasmolysis). Colonoscopy may be helpful in excluding carcinoma of the large bowel. Patients with diverticulosis and uncomplicated diverticulitis should be managed conservatively by medical treatment. The following measures proved to be successful: high-fibre diet, unprocessed wheat bran, and hydrophilic plant colloids to regulate the bowel movements, systemic or local antibiotics if signs of inflammation are present, and antispasmodics or analgesics against abdominal pain. Prognosis depends mainly on the duration of the disease, sufficient dietary-fibre intake, and elective or semi-elective surgical intervention before the development of life-threatening complications. The question as to whether diverticula or relapsing attacks of diverticulitis can be prevented with added dietary-fibre remains open for the time being.
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PMID:[Diverticulosis-diverticulitis]. 628 28

The colo-uterine fistula is a rare complication of diverticular disease of the colon; the literature review has shown only few well studied cases. The fistula, among the complications of the sigma diverticulitis, is 20% of the observed cases; generally, the bladder is the most involved organ, but also the skin or gut can be interested. If we consider the aetiology of the colo=uterine fistula of the observed case, the presence of the sigma locked stenosis with an endocolic pressure increase, associated with a peridiverticulitis condition, seems to have a relevant rule. The clinical symptomatology is represented by vague abdominal pain localized in particular in the left iliac cavity and by emission of blood, purulent material and stools from the vagina. The diagnosis of colo-uterine fistula is not easily reached: barium enema, Fallopian tube endoscopy and colon endoscopy not always allow to visualize in a right manner the fistula and only the oral administration of non-absorbable substances to be searched in the vaginal tampon, clear each doubt. Regarding the therapy to be carried out, we think that, colic resection en bloc with the uterus is the treatment of choice, while, in emergency, the Hartman operation is the most suitable to avoid the beginning of septic complications.
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PMID:[Colo-uterine fistula, a complication of sigma diverticulitis]. 988 74