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)

A 61-year-old female complaining of arthralgia was repeatedly treated with antibiotics and also with prednisolone. A chronic polyarthritis was assumed. In hospital, leukocytosis of 21.000 was found one day before death as well as moderate anemia. Colonoscopy was rejected by the patient. A computer tomography revealed destructive arthritis of the symphysis, vertebral osteochondrosis L5/S1, and sigmoid diverticulosis. The patient died with clinical signs of central dysregulation. At autopsy, a covered perforation of a sigmoid diverticulum with purulent peridiverticulitis was found. The 5th lumbal vertebra and the symphysis showed hematogenic abscesses. Microabscedating pneumonia, purulent meningitis and hypophysitis, and mycotic aneurysm of the basilar artery with lethal rupture were further results of hematogenic spread. Death was caused by massive subarachnoidal hemorrhage. This history is not untypical for elder patients with complicated diverticular disease. The intestinal perforation is often clinically occult due to only few and unspecific symptoms which cannot be exactly attributed to the colon. In the last ten years, we have found lethal complications of sigmoid diverticulitis at a frequency of 0.32% (5 cases in 1.557 subsequent autopsies). The clinical differential diagnosis included diverticulitis in none of the cases. This underlines the importance of autopsies for quality control in medicine, because modern diagnostic methods such as computer tomography were not able to give the correct diagnosis in these cases.
 ...
PMID:Lethal complications in a case of sigmoid diverticulitis. A case report. 906 89

A 66-year-old male with a history of hypertension, back pain, diverticulosis and anal fistula presents with acute onset syncopal episodes, worsening back pain, and altered mental status. The patient exhibited considerable leukocytosis but was hemodynamically stable. CT imaging of the head revealed a gas pattern in the posterior fossa and velum interpositum. CT imaging of the abdomen and pelvis revealed a needle-like foreign body traversing the left sacrum to the sigmoid colon. A lumbar puncture revealed meningitis. Flexible sigmoidoscopies were performed without successful visualization of the foreign body. An explorative laparoscopy was successfully performed, enabling retrieval of what was determined to be a wooden toothpick. The patient remained hemodynamically stable with persistent altered mental status and was eventually discharged after completion of antibiotics on day 47 of hospitalization. This case illustrates a rare complication of ingesting a sharp foreign body that was identified by CT of the brain and abdomen/pelvis with successful surgical repair.
 ...
PMID:Toothpick meningitis. 2849 Nov 66