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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There were found 368 cases (4.5 percent) of diverticulosis of the intestine based on 8124 autopsies in the years of 1979 till 1988 with regard to their localisation, complications and accompanied diseases. In 174 of 368 cases clinical files could be examined and integrated in the evaluation. Sigmoid diverticula were most frequently followed from duodenal diverticula chiefly in the immediate vicinity of the "Papilla of Vateri". Constipation, stomachache, haemorrhoids and spasm of the anal sphincter were typical complaints. One during lifetime known diverticulosis was noted only approximately half on the autopsy application as a second disease. The autopsy results a complication of diverticula (mostly with a peritonitis) in 39 percent as the primary cause of death. Most frequently complication was a diverticulitis (in 16.8 percent refer to the total number). Arteriosclerosis, hypertension and/or diabetes (so called "civilization diseases") were in the main accompanied diseases, which were found too. Surgical intervention took place principal under suspicion of malignoma or as an "acute abdomen". Non-characteristic complaints (protraction by the physician) and the ignorance of the illness among the population (protraction by the patients) are disadvantageous to the identification of the diverticulosis. Because the diverticulosis as a disease of the economic developed countries represents a growing problem ought to direct more attention to prevention, which consists in application of food rich in ballast-substances and the treatment of the constipation.
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PMID:[Diverticular disease. Pathology and clinical aspects based on 368 autopsy cases]. 174 79

People who refuse to eat meat animal products mostly adhere to vegetarianism, veganism, crudivorism or macrobiotism, But these food habits are only one part of life-style chosen for spiritual, ethic or hygienic and healthy motivations. Except vitamin B12 deficiencies these regimens do not produce other deficiencies if they are correctly followed and if the energy intake is in agreement with the RDA'S. They reduce the risks of metabolic diseases, coronaropathies, arterial hypertension, colon cancer, diverticular disease of the colon, kidney and gallstones. Nevertheless crudivorism and macrobiotism are associated with high risks of deficiencies especially in children and pregnant women.
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PMID:[Diet peculiarities. Vegetarianism, veganism, crudivorism, macrobiotism]. 206 9

Reports of adults with Williams syndrome (WS) have been rare. We have evaluated 13 adult WS patients and reviewed 16 case reports of WS in patients older than age 16 years. Adults in our study had progressive multisystem medical problems. Cardiovascular complications were common (12/13) including hypertension (8), supravalvular aortic stenosis (9), aortic hypoplasia (3), pulmonic artery stenosis (4), peripheral stenoses (3), and mitral valve prolapse (2). Joint limitation (12/13) was progressive, often accompanied by kyphoscoliosis and lordosis. Recurrent urinary tract infections in 6 individuals led to radiologic studies showing urethral stenosis in 2, and bladder diverticula and vesicoureteral reflux in 3. Gastrointestinal problems included obesity (5), chronic constipation (7), diverticulosis (3), and cholelithiasis (4). Hypercalcemia was documented in 5 patients, although others had hypercalcemic symptoms (abdominal pain, polyuria, and constipation). One 45-year-old man had parathyroid hyperplasia. Previous reports likewise document significant morbidity. Thus, Williams syndrome in an adult appears to dictate aggressive evaluation and monitoring. Investigation of calcium metabolism should be undertaken in each adult WS patient.
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PMID:Adults with Williams syndrome. 189 83

The term "obstructive colitis" refers to ulceroinflammatory lesions occurring in the colon proximal to an obstructing or potentially obstructing lesion. We studied nine cases identified over a 9-month period. The patients were predominantly female (only one was male), elderly (mean age, 73), and usually had hypertension, diabetes, or other prior chronic illness. The colonic obstruction was due to adenocarcinoma in seven cases and to diverticular disease in two cases. Areas of colitis occurred either as circumscribed ulcers 0.5-2 cm in diameter (three cases) or as confluent circumferential lesions 8-25 cm in length; they were always separated from the more distal obstructing lesions by a segment of normal colon measuring 2.5-35 cm (mean, 14.6 cm). The involved area of colon was usually only mildly dilated; it exhibited moderate thickening of the wall and had a granular luminal surface accentuated in areas by deeper longitudinal or transverse ulcers. Often there were scattered pseudopolyps, and the margin separating the lesion from normal mucosa was well demarcated and irregular. In one case, two distinct separate areas of colitis were present; in another, the appendix was acutely inflamed. Microscopically, the lesions were composed of granulation tissue with a mixed acute and chronic inflammatory infiltrate that replaced the mucosa and often the submucosa; sometimes it extended into the muscularis propria, with associated peritonitis and perforation. Many of the features of obstructive colitis suggest an ischemic origin, probably mainly due to hypoperfusion following raised intramural pressure, but altered fecal flora may have a synergistic effect. The features of the disease are usually sufficiently characteristic to distinguish it from Crohn's disease and other forms of colitis. Complications include peritonitis, perforation and breakdown of anastomoses made through involved segments of colon that may appear externally normal at surgery.
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PMID:Obstructive colitis. Ulceroinflammatory lesions occurring proximal to colonic obstruction. 237 93

Recent studies of vegetarian diets and their effects on morbidity and mortality are reviewed. Vegetarian diets are heterogeneous as are their effects on nutritional status, health, and longevity. Mortality rates are similar or lower for vegetarians than for nonvegetarians. Risks of dietary deficiency disease are increased on vegan but not on all vegetarian diets. Evidence for decreased risks for certain chronic degenerative diseases varies. Both vegetarian dietary and lifestyle practices are involved. Data are strong that vegetarians are at lesser risk for obesity, atonic constipation, lung cancer, and alcoholism. Evidence is good that risks for hypertension, coronary artery disease, type II diabetes, and gallstones are lower. Data are only fair to poor that risks of breast cancer, diverticular disease of the colon, colonic cancer, calcium kidney stones, osteoporosis, dental erosion, and dental caries are lower among vegetarians. Reduced risks for chronic degenerative diseases can also be achieved by manipulations of omnivorous diets and lifestyles.
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PMID:Health aspects of vegetarian diets. 304 2

From January 1986 through December 1992, 9 cases of diverticular disease of the colon have been surgically operated in our department. In 56% of the cases, diverticula were located in the left side, in 33% in the right side, and in 11% in the both sides. 67% cases had a complication of hypertension, 33% cases had hypoproteinemia, and 78% cases had anemia. Moreover, 67% cases had hyperlipidemia. Only one case had a minor leakage in the anastomosis after colectomy, which was cured by intravenous hyperalimentation. These results suggest that such a complication should be taken into consideration in the surgical treatment of diverticular disease of the colon, although the disease is in itself a benign disease.
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PMID:[Operative cases of diverticular disease of the colon: in comparison with colo-rectal cancers]. 809 23

Autosomal dominant polycystic kidney disease is one of the most commonly inherited diseases in the United States. It affects nearly 500,000 Americans and accounts for 5 to 10 percent of patients with end-stage renal disease. Diagnosis is usually made in middle age, when complications such as hypertension, pain and hematuria develop. Renal complications include hypertension, cyst infection and hemorrhage, hematuria and flank pain. Other manifestations and related conditions include polycystic liver disease, cerebral aneurysm, cardiac valve abnormalities and diverticulosis. The severity and course of the disease vary in individual patients. Management involves the control of hypertension and treatment of complications. Genetic counseling is important. Dialysis and renal transplantation often are successful treatments in patients who develop renal failure.
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PMID:Autosomal dominant polycystic kidney disease. 859 59

The object of this study was to assess the outcome of laparoscopic colorectal surgery in patients >60 years of age and compare it to a younger group of patients who underwent similar procedures. All consecutive patients who underwent a laparoscopic or laparoscopic-assisted procedure were evaluated. The parameters analyzed included gender, indication for surgery, procedure, complications, conversions, length of ileus, length of hospitalization, and comorbidity. The results of patients 60 years of age or older were compared to a procedure-matched group of younger patients. Between August 1991 and August 1995, 165 patients underwent a laparoscopic or laparoscopic-assisted colorectal procedure. Thirty-six patients were 60 years of age or older [mean age, 73 (60-88) years; 17 males and 19 females] and were compared with 36 younger patients [mean age, 44 (20-58) years; 13 males and 23 females]. The indications for surgery included Crohn's disease in 14 patients, polyps in 23, diverticular disease in 15, carcinoma in 11, fecal incontinence in 4, rectal prolapse in 2, radiation proctitis in 2, and sigmoidocele in 1. Identical procedures were performed in each group including right colectomy or ileocolic resection in 17 patients, sigmoidectomy in 14, loop ileostomy in 3, loop colostomy in 1, and abdominoperineal resection in 1 patient. Fourteen patients (38%) in the elderly group had comorbid conditions including ischemic heart disease (3), chronic obstructive pulmonary disease (3), hypertension (2), chronic renal failure (2), atherosclerotic vascular disease (2), congestive heart failure (1), and diabetes (1). All patients were cleared for surgery by their respective specialists. There were no statistically significant differences between the younger and older groups relative to the incidence of complications (11 vs 14%, respectively) and conversion (8 vs 11%, respectively) or the length of ileus (2.8 vs 4.2 days, respectively) or hospitalization (5.2 vs 6.5 days, respectively) (P = NS for all). There was no mortality in either group. The outcome of laparoscopic colorectal surgery in older patients is similar to that noted in younger patients. Advanced age should not be a contraindication to laparoscopic colorectal surgery.
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PMID:Outcome of laparoscopic colorectal surgery in older patients. 895 49

Right-sided colonic diverticular disease is a distinct disease entity uncommon in the West. Occasionally, the condition may be complicated by hemorrhage and present as lower gastrointestinal bleeding. We report a series of 25 cases of bleeding right colon diverticulosis and discuss its presentation and management. Patients were selected from the colonoscopic reports of all 190 patients presented with suspected acute lower gastrointestinal bleeding in National University Hospital, Singapore, from 1988 to 1994. Fifty-seven patients (30%) had bleeding diverticulosis in which 25 patients (44%) suffered from right-sided disease. Sixty-four per cent of patients had a history of hypertension. Patients presented with either fresh blood in stools or melena. Fifteen patients (60%) required blood transfusion (median, 2 units). Colonoscopy showed blood clots in the right colon in 15 cases (60%) and active bleeding from the right colon diverticula in 3 patients (12%). The bleeding stopped spontaneously in 16 patients (64%). The other 9 patients required surgery because of continuous or recurrent bleeding. All had a right hemicolectomy performed. The hospital stay was 13 days in this group, compared with 5 days for those undergoing conservative treatment (P = 0.0004). There were no deaths. No patients had further bleeding episodes during a median 7-month follow-up.
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PMID:Right-sided colonic diverticular disease as a source of lower gastrointestinal bleeding. 1019 Mar 49

By computer search of the literature, we found few cases of hydronephrosis due to fecal impaction. Because such a complication is extremely rare, we describe an 81-year-old woman with dementia, gallstones, arterial hypertension, and diverticulosis of the sigma who was hospitalized for severe constipation, fecaloma, and bilateral hydronephrosis. Through simultaneous lavage by two rectal tubes and manual disimpaction of fecaloma, bilateral hydronephrosis was resolved. We also briefly review the appropriate literature.
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PMID:Bilateral hydronephrosis due to fecaloma in an elderly woman. 1077 77


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