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

Diverticulosis of the ascending colon is rare. Perforation of a diverticulum is very uncommon and at times it is difficult to differentiate from carcinoma. Two unusual cases of perforated solitary diverticula of the ascending colon are reported, and literature is briefly reviewed.
Dis Colon Rectum
PMID:Solitary perforated diverticulum of the ascending colon: report of two cases. 747 3

Colon diverticular disease is an increasingly frequent disorder especially in Western populations characterized by high living standards. In 30-40% of subjects over 60 years of age barium enema detects the presence of diverticula in the sigma. 10-20% of patients affected by colon diverticular disease develop complications such as inflammation or haemorrhage and 20-30% of these patients undergo surgery (60% of patients aged less than 40). Emergency surgery is performed in 50% of cases and it is currently burdened by high mortality rates. We decided to review our cases history to clarify the indication for emergency surgery, the appropriateness to resect the diseased bowel tract and to perform colic anastomosis at the time of emergency resection.
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PMID:Emergency surgery of complicated colonic diverticulitis. 814 Aug 34

One case of the semilunar valve of the cardial oesophageal aperture in a 86-year-old female is described. The condition simulated carcinoma and resulted in the development of megaesophagus with a diverticule and forestomach formation. Colon diverticulosis was also observed. The complex of clinical and morphological manifestations characterizes this pathology as a peculiar syndrome. Syndrome of the semilunar aperture into the stomach with formation of the megaoesophagus, diverticules, forestomach and colon diverticulosis-Shmurun's syndrome.
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PMID:[A rare defect of esophageal development, simulating cancer]. 929 31

A case of multiple lipomatosis exclusively located in the colon is reported in a young male (33 years). It is characterized by a great number of lipomas with polyposis growth appearance, multiple lipomas of peritoneal folds, and giant diverticulosis probably caused by weakened areas of colonic wall induced by the lipomas.
Dis Colon Rectum 2000 Dec
PMID:Lipomatous polyposis of the colon with multiple lipomas of peritoneal folds and giant diverticulosis: report of a case. 1115 66

Colon diverticular disease is a very common pathology in western countries and represents a risk factor for septic-type complications, especially in peritoneal dialysis patients. We examined both diagnostic procedure and therapeutics options, either pharmacological or surgical. Ultrasonography, which is useful for the diagnosis of diverticulosis and diverticular disease, has been supported in the last few years by new imaging techniques, such as NMR and CT, that also find applications in the treatment of diverticulitis complications like peritoneal abscesses. Our emphasis is on the therapeutic perspective, either dietetic - based on the use of a fibre-rich diet and the infusion of liquids by intravenous injection - or surgical, such as the Hartmann procedure, single anastomosis with stomia conservation and laparoscopic and endoscopic treatment. These therapeutic approaches have reduced both morbidity and mortality rate and have emphasized how the reduction of surgical stress on the mesothelium promotes the recovery of the functional integrity and, consequently, faster resumption of peritoneal dialysis. In conclusion, diverticulosis alone is not a contraindication for peritoneal dialysis, but constitutes a risk factor for the continuation of this alternative treatment.
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PMID:[Diverticular disease of the colon in peritoneal dialysis]. 1243 43

This study reports on 10 years of experience in observing diverticular disease. The study considers 77 patients, 41 males and 36 females, aged from 50 to 88 years (mean age: 70 years), observed from January 1991 to December 2001. Sixty-two patients were admitted from the Accident and Emergency Unit and 15 were elected patients. Five patients underwent emergency surgery, while 72 received only antibiotic therapy. The overall mortality rate was 0. The morbidity rate was 22% in those patients undergoing emergency surgery. In only one of the elected patients was wound suppuration detected. Diverticular disease, in most cases, is treated by antibiotic therapy alone, but in 30% of cases surgery is necessary. Colon resection and immediate anastomosis are the first choice operation also in the emergency setting, provided local conditions (inflammation, septic contamination) make anastomosis safe. In patients with major peritoneal contamination, Hartman's operation and subsequent recanalization after 6 months are to be preferred.
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PMID:[Diverticular disease: complications and treatment]. 1246 67

Colon diverticular disease is one of the most common pathologies of the western world; the aim of our review was to collect shortly but in a systematic way the main and more recent news on the etiopathogenesis, prevention, natural history, possible clinical presentations and complications of this disease without omitting, at the end, a short report on the diagnostic techniques and on the various medical and/or surgical therapy.
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PMID:[Diverticuli of the colon]. 1294 3

Colon perforation due to diverticulitis is a life-threatening complication in the postoperative course of kidney transplantation. In the immunocompromised patient a diagnosis of diverticulitis is difficult to make. We report a 53-year-old woman being kidney transplanted 14 years ago with known diverticulosis. She was admitted with acute severe pain in the lower left abdomen. Abdominal computed tomography (CT) scan indicated a diagnosis of intestinal abscess in the small pelvis. Laparotomy showed a covered sigma perforation with abscess located in the small pelvis (Hinchey-I). Because of the immunocompromised situation of the patient we performed a Hartmann procedure. Her postoperative course was uneventful. In a 6-month interval the intestinal continuity restoration was performed. Twelve days after discharge the patient was readmitted with reduced renal function and increased infection parameters. During physical examination the abdomen was tender. The patient complained of abdominal pain in the left upper abdomen and additional pain in the left shoulder. An antibiotic therapy using ciprofloxacin was already initiated owing to a urinary tract infection. An abdominal CT scan was performed and indicated an intestinal abscess in the left upper abdomen. Laparotomy showed an abscess involving transverse colon, distal jejunum, and proximal ileum (Hinchey-II). Segmental resection of the left colonic flexure, proximal jejunum, and ileum was performed. The postoperative course was uneventful and the patient was discharged on the 8th postoperative day. The present casuistry emphasizes that the immunocompromised patient can undergo diverticulitis twice, and that primary anastomosis is a feasible option for patients with localized peritonitis due to complicated diverticulitis.
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PMID:Recurrent complicated colon diverticulitis in renal transplanted patient. 1664 53

Colon diverticular disease presents in 10%-25% of cases when a complication arises. Helped by Hinchey's classification, the surgeon can choose from among the following therapeutic strategies: a) medical treatment; b) one-stage resection and anastomosis with or without a protective colostomy; and c) resection according to Hartmann. The increasingly widespread use of laparoscopic techniques, though generally improving surgical outcomes, has perhaps made the choice of treatment more difficult, because it has extended the range of indications, both in the elective and emergency setting. From January 1999 to December 2004 411 patients (174 men and 237 women) affected by symptomatic diverticular disease were admitted to our surgical department and 94 of these (22.8%) underwent surgery: 41 of them (43.6%) underwent a true emergency operation, while for 53 of them surgery was delayed (within one week). None of the patients undergoing resection-anastomosis had a protective colostomy. The total morbidity was 3.7% and total perioperative mortality 1% (one patient undergoing surgery with the Hartmann procedure). More than one year after the end of the research there was no need for operation of any of the non-surgical patients and no deaths due to diverticular disease were recorded. On the basis of our experience we may conclude that a one-stage resection, even in the emergency situation, is possible and yields excellent results, while preventive resection would not currently seem justified.
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PMID:[Complicated diverticular disease of the colon: 5 years' experience in a provincial hospital]. 1750 Jan 76

Diverticulitis in the young is often regarded as a specific entity. Resection after a single attack because of a more "virulent" course of the disease has been accepted as conventional wisdom. The evidence for such a recommendation and the place of elective surgery was reviewed by a search of Medline, PubMed, Embase, and the Cochrane library for articles published between January 1965 and March 2008 using the terms diverticular disease and diverticulitis. Publications had to give specific information on at least ten younger patients (age <or= 50 years). Much of the older literature suggests that young patients experience a more virulent course with diverticulitis. Previous studies have shown misclassification and selection bias. As a result leading to a bias for more severe cases to be recognized mild cases may not be included. Young patients appear more likely to undergo operations to resolve an uncertain diagnosis. Recent studies have raised doubts about a virulent course with diverticulitis suggesting that recurrence may be associated with disease severity on CT scan, and supporting a conservative approach to diverticular disease. The diagnosis of diverticulitis is often delayed in younger patients because it is not considered, resulting in presenting cases being found at surgery or appearing more severe and more likely to be complicated. There is a lack of evidence to support the hypothesis that elective surgery should follow a single attack of diverticulitis. Any increased risk appears be a chronologic rather than pathologic phenomenon. Most patients will not have further episodes of diverticulitis.
Dis Colon Rectum 2009 May
PMID:The place of elective surgery following acute diverticulitis in young patients: when is surgery indicated? An analysis of the literature. 1950 72


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