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

While diagnostic laparoscopy is a well established tool, therapeutic laparoscopy for acute abdominal disorders has recently been made possible by video-endoscopic techniques. From July 1989 to April 1992, 243 laparoscopic interventions were carried out in patients with an acute abdomen. After a pilot phase, patients with acute appendicitis were entered into a randomized trial, those with acute cholecystitis were operated within the next day list. Among the 243 operations were 202 appendectomies, 12 closures of perforated peptic ulcers, 4 successful interventions for intestinal obstruction, 4 irrigations for intraabdominal abscesses and 35 further operations, some of which had to be finished as laparotomies. Laparoscopic appendectomy was less painful but technically more difficult. In cases which needed bowel resection for ischemic necrosis or diverticular disease, conversion to open surgery had to be performed. Laparoscopic treatment of acute abdominal disorders including peritonitis can be effective and beneficial in one out of two patients. Adequate surgical training, expertise and respect to the safety of the patient are mandatory. The application of endoscopic suture devices will further enlarge the spectrum of laparoscopic treatment options for the acute abdomen.
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PMID:[Value of laparoscopy in diagnosis and therapy of the acute abdomen]. 814 45

The clinical diagnosis of diverticulitis is often uncertain and frequently incorrect. Diagnostic imaging such as with helical CT offers a rapid and accurate diagnosis of diverticulitis and its complications as well as alternative conditions. In particular, helical CT combined with contrast material administered through the colon is highly accurate and can be obtained quickly. CT signs of diverticulitis include focal inflammatory wall thickening and paracolic inflammation superimposed on diverticular disease (diverticula, muscular wall hypertrophy). Common alternative conditions that can clinically mimic diverticulitis include small bowel obstruction, primary epiploic appendagitis, acute cholecystitis, appendicitis, ileitis, ovarian cystic disease, and ureteral stone disease. Early and frequent use of diverticular CT promises to improve diagnosis and treatment of patients with clinically suspected diverticulitis.
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PMID:CT of diverticulitis and alternative conditions. 1022 17

Laparoscopy has become a routine procedure in the management of acute abdominal disease and can be considered both an excellent therapeutic and additional diagnostic tool in selected cases. However, a high level of expertise in laparoscopic and emergency surgery is required. Hemodynamic instability, huge abdominal distension, fecal peritonitis and perforated cancer are relative contraindications for the laparoscopic approach. In recent years, abdominal emergencies have increasingly been managed successfully by laparoscopy. In acute appendicitis, acute cholecystitis and perforated peptic ulcer, randomized controlled trials have proven that the laparoscopic approach is as safe and as effective as open surgery, with fewer complications and a quicker postoperative recovery. Other indications such as blunt and penetrating trauma to the abdomen, small bowel occlusion and perforated diverticular disease are under debate, indicating that more randomized controlled trials comparing laparoscopic and open surgery are still necessary.
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PMID:Laparoscopy in the acute abdomen. 2448 51

Luschka ducts (LD) of the gallbladder (GB) are rare congenital lesions. They are defined as bile ducts that connect directly the hepatic bile duct system to the GB. We aimed to present the characteristics of 55 cases of GB LDs as diagnosed on cholecystectomy specimens. Surgically resected GBs (55) were analyzed for LD morphological features (length, morphological pattern, and epithelial lesions) as well as for immunohistochemical features. The age varied between 24 and 88 years. The gender ratio was 30:25 (female-male). The diagnosis was acute and subacute/chronic cholecystitis (21 and 34 cases, respectively). GB abnormalities of Rokitansky-Aschoff sinus, adenomyoma, septate, and subserosal-liver types were present in 36, 6, 22, and 12 GBs, respectively, while adenocarcinoma was present in 2 GBs. A history of renal cyst, pancreatitis, and colon diverticulosis was observed in 8, 11, and 4 cases, respectively. The LDs were detected at subserosal, resection, or both sites (25, 4, and 26 cases, respectively). The length varied between <1 and 36 mm. Duct-type LDs were observed in 17 cases, complex-type LDs in 5 cases, and mixed-type LDs in 33 cases. Mucosecretion was seen in 12 LDs and cystic dilatation in 8 cases. Epithelial atypia was observed in 2 cases and meganucleoli in 15 cases. Presence of LD-angulation correlated with chronic cholecystitis, while LD-nuclear atypia correlated with acute cholecystitis. In conclusion, LDs may harbor varied aspects, from duct-like or cystic, to nodular, biliary adenoma-like complexes. GB abnormalities of Rokitansky-Aschoff sinus, septa, or subserosal-liver types and extra-GB lesions such as renal cysts, pancreatitis, and colon diverticulosis were associated.
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PMID:Luschka Ducts of the Gallbladder in Adults: Case Series Report and Review of the Medical Literature. 3198 63