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Query: UMLS:C1510475 (diverticular disease)
 2,138 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The place of longitudinal myotomy in the treatment of diverticular disease of the sigmoid colon is discussed, with passing reference to the drawbacks of transverse myotomy. The prime indication for longitudinal myotomy is in the longstanding uncomplicated case of troublesome diverticular disease that has not responded to correct medical treatment, which should include high-residue diet and bran. Such cases are usually over 50 years of age, when a functional and reversible obstruction has become organic and irreversible. They comprise 75% of a series of 104 cases described. A secondary indication is in cases of diverticular disease which have been complicated by perforation, abscess formation, acute intestinal obstruction or fistulae. Such cases comprise 25% of the present series. They may settle after drainage and/or defunctioning colostomy. Myotomy can be carried out later, with or without limited resection, provided that all signs of pus or peritonitis have disappeared. The technique of the operation is described and the results are analysed.
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PMID:The place of sigmoid myotomy in diverticular disease. 52 73

A case of distal ileal diverticulosis complicated by diverticulitis causing partial small bowel obstruction is presented. To the author's knowledge, this is the first reported case of such obstruction, and the third reported case of preoperatively diagnosed ileal diverticulitis. This diagnosis should be considered in patients with acute abdominal symptoms and/or small bowel obstruction.
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PMID:Partial small bowel obstruction secondary to ileal diverticulitis. 83 68

Under observation were 47 patients with colonic diverticula. The clinical classification of diverticulosis of the colon is suggested. The principal method of treatment in patients with uncomplicated forms of the diverticulosis should be conservative. In profuse hemorrhage and intestinal obstruction as well as in perforation of the diverticulum, that would not respond to conservative therapy, surgery is indicated.
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PMID:[Diverticulosis of the large intestine]. 108 62

A case of intestinal obstruction due to impaction of an enterolith in the distal ileum is reported. The patient had jejunal diverticulosis. One of the diverticula showed evidence of acute inflammation and another showed signs of fibrosis suggesting previous inflammation. Apparently the enterolith had been released from the acutely inflamed diverticulum. One of the diverticula contained a smaller enterolith. The impacted enterolith was removed by enterotomy and the smaller one milked into the intestine. Chemical analysis of the removed stone showed that it consisted of mainly cholic, desoxycholic and fatty acids.
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PMID:Enterolith obstruction of the ileum as a complication of jejunal diverticulitis. Report of a case. 121 49

Our experience with 431 patients suffering from diverticular disease is presented. Indications for emergency (severe bleeding, bowel obstruction, sigmoid perforation with peritonitis) and elective surgery (recurrent attacks of diverticulitis or bleeding, painful or obstructing diverticular disease, fistula, impossibility to exclude a cancer) are given. Resection of the perforated sigmoid by the Hartmann procedure helps to reduce mortality markedly for diffuse purulent and fecal peritonitis. A resection with primary anastomosis can be performed with equal safety for a more localised peritonitis. Aggressive indication for elective surgery helps to lower mortality and morbidity in symptomatic diverticular disease.
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PMID:[Surgical therapy of diverticular disease at the Waid City Hospital, Zurich, 1980-1990]. 159 47

The authors report ten cases of small bowel diverticulosis revealed by a complication in four cases. Aetiologic, pathological, clinical and therapeutic characteristics of this rare disease are reviewed. Main complications are perforations, intestinal obstruction and hemorrhage. The treatment was the resection of the segment of small intestine involved by complicated diverticula. Resection was followed by anastomosis or temporary enterostomy if there was an acute peritonitis. Uncomplicated diverticulae must be respected and left in place.
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PMID:[Jejuno-ileal diverticula (Meckel excluded). Apropos of 10 cases]. 160 34

The successful application of laparoscopic surgery to gallbladder disease and acute appendicitis has encouraged clinical investigators to develop this technology further in an attempt to manage other pathologic disorders of the gastrointestinal (GI) tract. After gaining experience with various laparoscopic skills while performing clinical biliary tract surgery, appendectomy and then in a controlled animal laboratory, a pilot program for laparoscopic colonic surgery was initiated. Twenty patients with ages ranging from 43 to 88 years (mean age of 57 years) underwent laparoscope-assisted colon resection. In nine patients, a right hemicolectomy was performed and a sigmoid colectomy in eight. A low anterior resection, Hartman's procedure, and abdominal perineal resection were each performed in one patient. Indications for surgery were large villous adenomas or adenocarcinoma in 12, diverticular disease in 5, sigmoid endometrioma in 1, cecal volvulus in 1, and inflammatory bowel disease in 1. Eighty percent of patients were able to tolerate a liquid diet on the first postoperative day and 70% were discharged within 96 h eating a regular diet and having normal bowel movements. There were three operative complications: a 3 unit postoperative bleed managed without surgery, one patient developed marked edema of the rectosigmoid anastomosis requiring decompression with a rectal tube, and one individual with metastatic colon cancer was operated on for a mechanical small bowel obstruction 7 days after the initial laparoscopic surgery. Although laparoscope-assisted colonic surgery may still be considered a procedure in evolution, we feel that in time it has the potential to be as popular as laparoscopic cholecystectomy.
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PMID:Minimally invasive colon resection (laparoscopic colectomy). 168 89

Jejunal diverticulosis is a rare condition and usually discovered incidentally at laparotomy for an unrelated pathology. When inflamed or perforated, jejunal diverticulosis may present with paralytic ileus. In contrast, mechanical bowel obstruction is an unusual presentation. This paper reports the first local case of jejunal diverticulosis presenting with mechanical bowel obstruction due to impaction at the terminal ileum by an enterolith originating from a diverticulum, and reviews the recent literature on the subject.
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PMID:Jejunal diverticulosis: case report of a rare cause of mechanical intestinal obstruction. 178 9

Small bowel diverticula, particularly the jejunal ones, are a rare disease with a poor and vague symptomatology. Sometimes detected by change under X-ray examinations or at surgery, they do not need any surgical treatment: only clinical and X-ray controls are required. Prophylactic resection of symptomatic low jejunal diverticula is controversial: patient's age and status will affect the indication to surgical treatment. Jejunal diverticulosis may generate serious, though not dramatic, symptoms: intestinal obstruction, inflammatory complications, haemorrhage, perforation of the diverticula are the most frequent emergencies which require an immediate surgical procedure. A clinical case is here reported.
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PMID:[Diverticulosis of the small intestine. Observations on a complicated case]. 190 42

Diverticulosis of the small bowel, complicated by enterolith formation with ensuing obturation obstruction, was recently documented in two patients. One patient had an enterolith formed within a Meckel's diverticulum; the other had an enterolith dislodged from an acquired diverticulum. Both patients presented with signs and symptoms of acute small bowel obstruction. Only 20 such cases of bowel obstruction secondary to jejunal enterolithiasis and five cases secondary to Meckel's enterolithiasis have been reported. The mechanism of obstruction may involve local encroachment or enterolith expulsion with distal bowel obstruction, although the latter is much more common. Optimally, enteroliths are broken up and milked into the proximal colon without incising the bowel. Alternatively, the enterolith may be milked proximally to a less edematous portion of bowel and an enterotomy may be performed. At times, the primary diverticulum is resected with the contained enterolith.
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PMID:Enterolith intestinal obstruction owing to acquired and congenital diverticulosis. Report of two cases and review of the literature. 191 31


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