Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C1510475 (diverticular disease)
 2,138 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three hundred cases of complicated diverticular disease were entered into a national audit organised by the Surgical Research Society from 30 hospitals between 1985 and 1988. Admission complications included acute phlegmon (n = 104), pericolic abscess (n = 34), purulent peritonitis (n = 40), large bowel obstruction (n = 31), faecal peritonitis (n = 23), pericolic abscess complicated by fistula (n = 28) and lower GI bleeding (n = 40). The overall mortality was only 11% (4% acute phlegmon, 27% purulent peritonitis, 12% pericolic abscess, 48% faecal peritonitis, 6% large bowel obstruction, 2.5% bleeding, 3.5% fistula). Acute phlegmon was managed non-operatively in 75% and by resection in 23%. Purulent peritonitis was generally managed by Hartmann resection (62%) or by resection and primary anastomosis (15%). Similarly pericolic abscess was usually managed by Hartmann resection (38%) or resection and primary anastomosis (35%). The principal operation for faecal peritonitis was Hartmann resection (83%). Large bowel obstruction was either managed conservatively (13%), by Hartmann resection (29%) or by resection and primary anastomosis with and without a proximal stoma (42%). Most fistulas associated with an abscess were managed by resection and primary anastomosis (82%) and acute GI bleeding was usually managed non-operatively (90%).
 ...
PMID:[Prospective national study of complicated diverticulitis in Great Britain]. 858 59

A survey was made in 13 Italian centers with a questionnaire concerning the (a) indications, (b) postoperative complications, (c) functional results and (d) diagnostic imaging modalities related to the making of an ileal or colonic (neo) rectum. Ulcerative colitis (100%), familial polyposis (61.5%) and Crohn's disease (15.3%) were the most common indications for an ileal pouch; rectal cancer (7.96%), chronic inflammatory diseases (15.3%), diverticulosis, rectal prolapse, redundant colon and imperforate anus (7.6% each) were the most common indications for a colonic pouch. Postoperative complications included pelvic abscess (14%), sinus tract/dehiscence (10%) and bowel obstruction (9%). When compared with the S and W variants, the J-shaped ileoanal pouch proved superior because urgency and fecal retention rates were lower (18.4% vs. 44.4% and 23% vs. 28.6%, p < 0.01 and p < 0.05, respectively), despite slightly more frequent staining episodes (15.8% vs. 11.1%; p < 0.05). As for colonic ampullae, fecal retention and provoked evacuation were more frequent in the J pouch and after gracileplasty; urgency and incontinence in the straight colo-anal anastomosis (33.3% vs. 22.2% and 41.6% vs. 33.3%, respectively). The functional outcome was assessed by anal endosonography (available in 4/13 centers), defecography and anorectal manometry. Abnormal findings included: (a) reduced capacity, barium leakage, anal gaping, sphincter damage (urgency and incontinence); (b) barium retention, pouch dilatation, split evacuation, knobs and strictures (fecal retention).
 ...
PMID:[The 3rd national workshop on defecography: the functional radiology of (neo) rectal ampullae (ileal reservoir, colo-anal anastomosis, continent perineal colostomy)]. 861 35

An increasing number of case reports and controlled trials have drawn attention to NSAID-induced side effects in the lower gastrointestinal tract. In this review we also report 9 cases of colonic ulcers and 7 cases of diaphragm disease of the ascending colon, most of them associated with the long-term intake of slow release diclofenac. NSAIDs not only can exacerbate preexisting conditions such as inflammatory bowel disease or diverticular disease, but may also induce de novo enteropathy, colitis, collagenous colitis ulcers and strictures. Complications such as bleeding, perforation or bowel obstruction may require surgery. From the literature and our own experience we conclude that the use of slow release formulations has shifted the toxicity of NSAIDs from the upper to the lower gastrointestinal tract. This must be considered in differential diagnosis and checked by endoscopy if appropriate.
 ...
PMID:[Nonsteroidal antirheumatic drugs and acetylsalicylic acid: adverse effects distal to the duodenum]. 866 76

The authors report a case of complicated multiple jejunal diverticulosis and review the data from the literature on this pathology. A 74-year-old man was admitted to our unit presenting with symptoms of intestinal obstruction. He had previously experienced three episodes of the same symptomatology with melena. Endoscopy excluded gastroduodenal or colonic bleeding; an X-ray of the small bowel detected multiple large jejunal diverticula. The patient underwent surgery: a jejunal resection was performed just below the Treitz angle extending about 60-70 cm. The postoperative course was uneventful and the patient was discharged on the 8th postoperative day. At present, the patient is doing well and has not since demonstrated any symptoms of either intestinal obstruction or melena.
 ...
PMID:Complicated jejunal diverticulosis: report of a case. 884 13

The colo-rectal emergencies are caused by perforation, penetration, large bowel obstruction, haemorrhage. Various acute colonic diseases have been clearly described as basic disease (traumatic events, malformations, inflammatory stenosis or functional obstruction, diverticular disease, cancer). Due to technological progress new diagnostic and surgical procedures have been introduced. This editorial symposium's aim is to study the radiological and endoscopic diagnosis and treatment and the surgical procedures in colo-rectal emergency.
 ...
PMID:[Emergencies in colorectal diseases. Introduction]. 892 28

An uncommon case of pneumoperitoneum without peritonitis, related to small bowel diverticulosis is presented. Pneumoperitoneum is usually a life-threatening incident, most frequently attributed to a perforated viscus and generally requiring emergency surgery. Non surgical pneumoperitoneum, however, is known to be caused by a variety of pathological and non pathological entities. Small bowel diverticulosis is an extremely rare cause of chronic pneumoperitoneum without peritonitis. In the presence of mechanical bowel obstruction, the latter kind of pneumoperitoneum can suddenly become impressively increased. A conservative attitude is generally advocated in the presence of such a benign pneumoperitoneum. However, laparoscopic exploration may be helpful for the diagnosis.
 ...
PMID:Acute pneumoperitoneum without peritonitis. A case report. 907 43

Sigmoid diverticular disease, when it occurs in a young age group, may follow a more aggressive course with a higher incidence of complications than in elderly. The mode of presentation and management in 77 patients under 50 years of age presenting with sigmoid diverticular disease over a 6-year period is described. Surgery for complications (peritonitis, abscess, bowel obstruction, fistula and haemorrhage) was performed in 18 (23%) individuals. Colonic resection was carried out in 14 (78%) of the operated group with primary anastomosis in six patients and Hartmann's procedure in eight patients. The mortality (30 day) was zero. Nineteen (25%) of the entire group, and 12 (67%) of those undergoing surgery had been previously hospitalized with a complication of diverticular disease. The recurrent nature and frequency of serious complications in this group, suggests that elective surgery should be considered if an acute infective episode is successfully managed conservatively.
 ...
PMID:Diverticular disease in patients under 50 years of age. 911 80

A case of small bowel obstruction secondary to enterolith impaction in the presence of jejunal diverticular disease is described. Only 27 cases of small bowel obstruction by enterolith expelled from small bowel diverticula have been reported in the literature. The reported incidence of jejunal diverticulosis in the general population ranges from 0.02 to 7.1%. Most patients are asymptomatic, but 10% develop complications requiring surgical intervention. Surgical treatment is an enterotomy and stone extraction or manually crushing and milking the stone distally into the colon. Small bowel resection and anastomosis or laparoscopic-assisted small bowel resection are indicated for the treatment of diverticulitis, bowel perforation, or multiple diverticuli. Jejunal diverticular disease should be considered in the differential diagnosis of mechanical small bowel obstruction without an obvious cause, especially in the elderly population.
 ...
PMID:Small bowel obstruction secondary to enterolith impaction complicating jejunal diverticulitis. 931 81

In the management of acute left colonic obstruction there is a tendency to perform immediate resection with anastomosis. We evaluated 27 consecutive patients (mean age 73.8 years) with acute left colonic obstruction and gross dilatation of the proximal colon treated by the "traditional" staged procedure. After caecostomy, no further resection was performed in two patients. In 25 patients, the obstructing tumour was resected after a median period of 14 days. In 17 (68%) patients the caecostomy was closed simultaneously. In 8 patients this was done at a third stage. Histologic examination revealed diverticular disease in 6 and adenocarcinoma in 19 patients. No deaths occurred after caecostomy nor was there major morbidity. After colonic resection, one in-hospital, nonprocedure related, death occurred (mortality rate 4%). In 21 patients with an anastomosis no dehiscence occurred. Other postoperative complications occurred in 5 patients (morbidity rate 20%). The median hospital stay for patients with a two-stage procedure was 32 days and with a three-stage procedure 39.5 days. The staged procedure in the management of acute colonic obstruction is still a safe and acceptable procedure in elderly patients with acute large bowel obstruction. To shorten the hospital stay the period between caecostomy and colonic resection should be reduced and it is best to close the caecostomy simultaneously.
 ...
PMID:Caecostomy in the management of acute left colonic obstruction. 939 62

The prevalence of diverticulosis in western countries has increased and two-thirds of the population over the age of 85 are now affected. Diverticulitis results from inflammation and subsequent perforation of a colonic diverticulum. Mild forms of diverticulitis usually present with gradually increasing symptoms from the lower left quadrant of the abdomen, whereas acute complicated disease is characterised by dramatic onset of abdominal pain, followed by fever within a few hours. The standard treatment for uncomplicated diverticulitis is bowel rest, with liquid diet or intravenous fluids in combination with antibiotics. Patients not responding to conservative treatment within the first 24 hours require further evaluation by computed tomography or ultrasonography. If an abscess is present, it can often be drained percutaneously. In cases of perforation and peritonitis, surgical intervention is mandatory, though no consensus exists as to the choice of procedure. Fistula formation and intestinal obstruction are also indications for surgical intervention, although the frequent recurrent attacks which commonly afflict these patients are seldom associated with severe complications. Prophylactic resection is not to be recommended for patients with diverticular disease, but a high-fibre diet may afford protection by preventing further complications.
 ...
PMID:[Diverticulitis is increasing among the elderly. Significant cause of morbidity and mortality]. 945 42


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>