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

Dietary habits in the civilised countries of the West with foods low in bulk and cellulose are blamed as causes of the increase in colon diverticulosis and the complicating diverticulitis in recent times. Of all sections of the colon, the sigmoid is most frequently involved, older patients above the 5th decade being principally affected. While uncomplicated diverticulosis of the colon usually remains symptomless, complicated diverticulitis often shows very uncharacteristic symptoms. For prophylaxis and the treatment of slight complaints, conservative treatment with administration of bulky foods (bran etc.) is indicated. Threatening hemorrhages and perforative peritonitis demand emergency operations. In closed abscess formation, internal or external fistulae and incipient scarring stenosis with imminent ileus, resection of the affected part of the intestine is indicated.
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PMID:[Colon diverticulosis and complicating diverticulitis (author's transl)]. 12 78

Admission diagnosis of 100 patients with diverticular disease of the colon indicated that the clinical features of the disease is still relatively unknown. The most important cardinal symptoms are abdominal complaints, irregular stools and/or bleeding from the large intestine. These symptoms occur with about equql frequency in patients with diverticular disease, whether or not there was evidence of inflammatory complications. If there is clinically manifest diverticulum formation of the colon, the term "diverticular disease" seems appropriate, since transition between diverticulosis and diverticulitis is fluid. In addition to bleeding and attacks of diverticulitis, fistulae and gut narrowing with or without ileus are other complications. Mechanical small-intestinal ileus with involvement of the small intestine in the inflammatory diverticulitis mass was a feature of several of the authors' cases. Low-residue diet is contra-indicated because such food probably plays an important part in the aetiology and pathogenesis of diverticular disease.
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PMID:[Diverticular disease of the colon (author's transl)]. 30 Oct 85

During the period from 1957 up to and including December 1975, the surgical clinic of Nijmegen admitted 82 patients with the diagnoses of diverticulosis and diverticulitis of the colon: the diagnosis of diverticulosis was made in 16 cases; in 17 diverticulitis was diagnosed and these patients were treated by conservative methods. Forty-nine patients were subjected to operation for diverticulitis. Of the patients treated conservatively, none died; of those treated by operation, three (6%) died. There were nine patients with peritonitis and three with ileus who required emergency surgery. As a matter of principle these patients were treated in several stages; none of them died.
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PMID:Findings in patients with diverticulosis and diverticulitis of the colon. 97 Sep 75

Diverticulosis is one of the most common diseases of the colon. Its importance arises from complications. In countries of the Western hemisphere the incidence is 10-20% beyond the age of 50. Among the natives of Africa and South-Eastern Asia it is practically unknown. It is suggested that the disease is caused by low residue diet, modern living conditions. and constitutional disorders. 500 barium enemas revealed 13,4% patients with diverticula including a 5-year-old child and a 32-year-old woman. The incidence of diverticulosis among patients over 40 years of age is 19,6%. The sex distribution is 1 : 1,9 male to female. The complications are demonstrated by case histories: Diverticulitis with ileus, foreign body trap, sub-acute perforation, sigmoid-vaginal fistula, sigmoid-bladder fistula, sigmoid-uterus fistula in a 5-year-old girl.
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PMID:[Diverticulosis of the sigmoid colon from the radiological point of view (author's transl)]. 100 10

One observation of total colon diverticulosis in a male of 62 is described. Clinical signs (abdominal pains, blood in faeces, vomiting) persisted for 7 years and was aggravated by ileus. Instrumental examination revealed multiple colon diverticula, stenosing villous tumour of sigmoid colon. Besides pseudodiverticula, chronic colitis with multiple inflammatory polyps stenosing the lumen of the sigmoid colon and simulating a villous tumour was found. The conclusion is made of the ischemic nature of the colitis complicating the course of diverticulosis.
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PMID:[Total diverticulosis of the large intestine, complicated by ischemic colitis with development of multiple inflammatory polyps]. 208 75

Six cases of diverticulosis of the small intestine are reported in this paper. Described in some detail is the pathological pattern of diverticula in jejunum and ileum. There are chronic courses with recurrent complaints in the epigastric region and with malabsorption syndrome which may lead to megaloblastic anaemia, steatorrhoea, and dermatosis. Acute processes are caused by perforation, diverticulitis, and haemorrhage. Ileus can develop owing to strangulation or, in less frequent cases, owing to incarceration of enteroliths. Chronic pneumoperitoneum may be attributable to massive jejunal diverticulosis.
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PMID:[Diverticulosis of the jejunum and ileum]. 311 92

Uncomplicated diverticular disease is usually asymptomatic. When abdominal pain or discomfort related to defecation, altered bowel habit, and flatulence occur, they are likely a result of a coexistent irritable bowel. Nonetheless, diverticula are subject to serious complications. Diverticular hemorrhage may be massive and require emergency angiography and segmental resection. Peridiverticulitis occurs when a diverticulum ruptures, perhaps because of inspissated fecal material. This occurs usually in the sigmoid, resulting in a peridiverticular abscess localized by the adjacent fat and mesentery. If the infection extends beyond this, abscess, fistula, or free perforation may occur. These complications require antibiotics, intravenous therapy, and, in the case of uncontrollable abscess or perforation, urgent surgery. Obstruction of the colon, sometimes associated with ileus, may occur and in this case one may find a carcinoma among extensive diverticular disease. Although there is insufficient evidence to justify a high-fiber diet for the general population, the notion of a low-residue diet in the management of uncomplicated diverticular disease should be laid to rest.
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PMID:Clinical picture of diverticular disease of the colon. 353 13

The indications for colonoscopy in a recent consecutive series of 232 examinations were analyzed. Of these examinations, 30 (13%) were performed for nontoxic megacolon. Nontoxic megacolon is defined as severe dilatation of a segment or the entire colon unaccompanied by signs or symptoms of colon toxicity. Mechanical factors (volvulus, anastomosis, diverticulosis, carcinoma) were responsible for the nontoxic megacolon in 13 of these patients. Nontoxic megacolon was classified as secondary to acute pseudoobstruction (Ogilvie's syndrome, pancolonic megacolon, acute myxedema ileus) in 17 patients. All patients were being evaluated for possible exploratory celiotomy to prevent perforation of the colon because of the massive colonic distention. Colonoscopic examination was performed at the bedside or in the intensive care unit for 11 of 30 patients. No bowel preparation was used. Evacuation of air and fecal material was more efficiently accomplished by use of an external suction device attached to the biopsy part of the endoscope. For 12 of the 13 patients who had a mechanical basis for their nontoxic megacolon the colon was successfully decompressed. All 17 patients with acute pseudoobstruction were successfully treated. There were no iatrogenic perforations. Possible emergency operation was avoided for all patients except one who had a cecal volvulus. Colonoscopy should be considered as the initial treatment for nontoxic megacolon prior to surgical intervention.
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PMID:Treatment of nontoxic megacolon by colonoscopy. 662 67

55 patients suffering from diverticulosis of the sigmoid colon underwent surgery, 32 of them in a state of emergency (peritonitis, ileus); mortality rate 22%. In 28 patients a colostomy was performed, which later on could be removed to restore the continuity of the colon. The therapy of choice in the early stage of diverticulosis is resection of the sigmoid colon performed as a ono-stage procedure (mortality rate les than 1%).
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PMID:[Treatment of complicated diverticulosis of the sigmoid colon (author's transl)]. 721 Sep 78

Motility disturbances of the large intestine, which appear in various conditions of a disease, are based on a reduction, the loss or an intensivation of the contractility as well as on a disorganization of the motor activity. Also in the region of the large intestine the normal motoricity can underlie such disturbances, such as retarded or accelerated passage, passage in wrong direction as well as increased turbulence or increased content. Retarded passage of the large intestine leads to obstipation and in advanced form to ileus. The leading symptom in accelerated passage is the diarrhoea. The passage in wrong direction disturbs the motoricity of the colon in the case of a lesion of the ileocaecal valves. Increased turbulence of the content of the large intestine is one of the causes of obstipation, particularly, when it appears in a retarded passage. The disturbances of the laminary flow are characteristic for a diverticulosis. The motor activity of the colon is influenced by many factors, mainly by the central nervous system, the gastrointestinal hormones (cholecystokinin, gastrin, serotonin, insulin and prostaglandins), the diet and the way of life. The motor disturbances are accompanied by bioelectric disturbances of the colon. In the second part of the lecture some pathogenetic and clinical aspects of the most frequently appearing motor disturbance of the large intestine, the irritable colon, are discussed.
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PMID:[Motility disturbances of the large intestine]. 722 37


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