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)

The authors describe the case of a 86-year-old female patient admitted to hospital with acute abdomen of the inflammatory type. The condition developed in the course of cca three days with sudden deterioration on the day of admission to hospital. Contrast X-ray examination revealed perforation of the distended jejunum and surgery revealed diffuse peritonitis the source of which was the mentioned perforation associated with mechanical ileus caused by malrotation and adhesions of the small intestine. An additional finding which, however, dominated on X-ray examination of the gastrointestinal tract when using contrast material and on revision of the peritoneal cavity was multiple diverticulosis of the small intestine. The uncommon finding on the small intestine and the relatively sparse data in the literature on diverticulosis of the jejunum and ileum made us submit the case-history for publication.
 ...
PMID:[Diverticulosis of the small intestine--case report]. 1091 42

The most frequent complications in diverticular disease are local abscess, perforation with peritoneal sepsis, fistula and ileus. Extraabdominal manifestation is an actual rarity. A haematogenous bacterial spread via portal vein with formation of liver abscess has seldom been described. But a complicated diverticular disease as a cause for a brain abscess is an absolute rarity. Our case presents a patient with brain abscess caused by asymptomatic, retroperitoneal perforated colonic diverticulosis. We discuss diagnostic steps both in diverticular disease and brain abscess and different surgical options in the treatment of colonic complicated diverticular disease.
 ...
PMID:[Brain abscess in retroperitoneal perforated colonic diverticulitis]. 1182 27

The diagnostic procedure is determined by the severity of the diverticulitis. In complicated cases of diverticulitis, it is necessary to detect those patients with obstructive ileus, perforation, and peritonitis who require instant emergency surgery. In all other cases, diagnostic procedures serve as a tool to determine the best therapeutic options. The CT scan of the abdomen seems to have the highest reliability for determining therapy. Other investigations such as barium enema and coloscopy are not indicated in emergency cases or cannot exactly describe the stage of the diverticular disease. Many surgeons still prefer an enema with water-soluble contrast medium in emergency cases to visualize a perforation. CT scans have the same ability to answer this question, but they are more expensive and are not available everywhere at any given time.
 ...
PMID:[Standards in diagnosis of diverticulitis]. 1224 74

We reported a case of 79-year old woman with known large bowel diverticulosis presenting with small bowel obstruction due to stone impaction - found on plain abdominal X-ray. Contrast studies demonstrated small bowel diverticulosis. At laparotomy, the gall bladder was normal with no stones and no abnormal communication with small bowel - excluding the possibility of a gallstone ileus. Analysis of the stone revealed a composition of bile pigments and calcium oxalate. This was a rare case of small bowel obstruction due to enterolith formation - made distinctive by calcification (previously unreported in the proximal small bowel).
 ...
PMID:A case of enterolith small bowel obstruction and jejunal diverticulosis. 1267 56

An elderly patient with subacute small bowel obstruction due to an enterolith that evolved within a small bowel diverticulum is reported. Presence of small bowel diverticulum is not rare. But small bowel obstruction secondary to an enterolith formed within a small bowel diverticulum is a rare complication. Enterolith ileus closely resembles gallstone ileus in its clinical presentation. Diagnosis can be established only by documenting the absence of aerobilia and the presence of small bowel abnormality causing stasis, like small bowel diverticulosis.
 ...
PMID:[Enterolith ileus: a rare complication of small bowel diverticulosis]. 1273 94

After a short literature review of diverticulosis of the colon and its complications, the authors give a thorough description of two cases treated by them for sigmoid colon diverticulosis complicated with occlusive ileus. The patients were males aged 68 and 74 years. In both cases the authors had difficulties in making the precise intraoperative diagnosis. Since exclusion of malignancy was impossible (in emergency conditions immediate histological verification was not possible). Hartman's operation ensuring oncological radicalism was performed. The intestinal passage was restored at the second stage of operation. The final histological verification detected chronic inflammatory process due to diverticulosis that had lead to stenosis and occlusion of the intestinal lumen. On the basis of the two cases described herein and the available literature data, the authors accept Hartman's operation as a method of choice in the treatment of occlusive ileus resulting from large intestinal diverticulosis in elderly patients in impaired general condition. If feasible in emergency conditions immediate histological examination should be used to exclude neoplastic process of the colon.
 ...
PMID:Occlusive ileus as a complication of large intestinal diverticulosis (contribution of two cases). 1294 69

This paper describes a rare right paraduodenal hernia discovered during an elective laparoscopic colon resection. Our patient was a 60-year-old Asian man with a history of multiple bouts of diverticulitis and a lifelong history of mild constipation and postprandial abdominal pain. Prior CT scans and preoperative barium enema confirmed the diagnosis of diverticular disease, and no other abnormalities were appreciated. At laparoscopic exploration, a right paraduodenal hernia was found with complete herniation of the small intestine under the ascending colon and hepatic flexure. The unclear anatomy prompted conversion to an open laparotomy. This allowed safe reduction of the hernia and sac excision. Adhesions were lysed to relieve a partial duodenal obstruction, and a Ladd's procedure was performed to correct the incomplete rotation. Additionally, a sigmoid colectomy was performed. After prolonged ileus, the patient was discharged on postoperative day 14. At 6-month follow-up, the patient was asymptomatic and doing well.
 ...
PMID:Incidental paraduodenal hernia found during laparoscopic colectomy. 1498 75

Jejunal diverticula are rare and usually asymptomatic; they occur twice as frequently in men. They are discovered incidentally during small-bowel enteroclysis, CT scan or laparotomy. Complications include diverticulitis, perforation, hemorrhage and enterolith formation. Intestinal obstruction due to enterolithiasis is uncommon. We present the association of enterolithiasis and jejunal diverticulosis causing obstruction of the small intestine in a 74-year-old female who was admitted for abdominal cramps, nausea and vomiting. On physical examination, there was discomfort on palpation of the upper abdomen. Laboratory tests revealed mild elevation of leucocytes and C-reactive protein. CT scan demonstrated dilatated loops of proximal jejunum with thickening of the wall, suggesting ingestion of a foreign body. Clinical and radiological findings did not indicate conservative therapy; our patient underwent minilaparotomy, and pronounced jejunal diverticulosis was identified. An enterotomy was performed and a cylindrical enterolith, 10cm long and 3cm in diameter, was removed. The operative and postoperative course was uneventful. Enterolithiasis must be considered as a potential source of intestinal obstruction. The differential diagnosis should take gallstone ileus and ingestion of a foreign body into consideration. Initial therapy is nonoperative; if this management fails, surgery is indicated.
 ...
PMID:Enterolithiasis in jejunal diverticulosis, a rare cause of obstruction of the small intestine: a case report. 1592 22

The adoption of the laparoscopic approach to colorectal resection has been slow amongst colorectal surgeons principally due to concerns regarding oncological safety. Recent randomized controlled trials have confirmed both the safe and some advantage of this procedure have been performing laparoscopic assisted colorectal resection since 2002 and have now performed over 100 cases on non consecutive and selected patients. We have reviewed our experience with the introduction of this technique. 61 patients were operated on for cancer and 39 for benign disease mainly Crohn's and diverticular disease. Operative time was a median of 128 minutes over the course of study. Conversion rate was 5%. Pathological analysis of the resected specimens in the cancer cases revealed adequate lymph node harvest and margins. No patient had a positive margin and no port site metastasis have been seen. Duration of ileus and length of stay were a median of 0 and 6 days. Post operative morbidity and mortality were comparable to open colorectal surgery with the exception of port site herniation which occurred in 4% of patients. This study suggests that a laparoscopic approach to colorectal resection can be successfully introduced in an Irish hospital setting. The challenge facing Irish surgery is to disseminate this technique in a controlled and safe manner for Irish patients.
 ...
PMID:Laparoscopic colorectal resection: initial experience in a specialist unit. 1698 67

Reversal of a Hartmann's operation can be a morbid undertaking; successful restoration of intestinal continuity cannot be guaranteed. Between June 2001 and July 2006, 35 Hartmann's reversals were undertaken. There were 19 males (54%). Mean age was 54.7 years (range, 14-82 years). Twenty-one (60%) patients had their Hartmann's for diverticular disease, 7 (20%) for anorectal cancer, 4 (11%) for volvulus, and 3 for miscellaneous reasons. Mean length of stay was 7.7 days (range, 3-16 days); 23 per cent required intensive care for a mean 2.3 days (range, 1-4 days). Blood loss was 470 mL, and mean operative time was 4.28 hours (range, 1-8.3 hours). The mean time interval between the original operation and its reversal was 8.9 months (range, 1.4-55 months). Extensive lysis of adhesions was required in 69 per cent, 40 per cent experienced minor complications (urinary tract infections, ileus, and so on), and 38 per cent had major complications (myocardial infarction, leak, hernias, respiratory failure). There was one death (3%). The operation failed because of intraoperative circumstances in three patients (8%). Ten patients (26%) had stomas at the time of discharge of which 3 were intended to be permanent and 7 were temporary. Of the latter, 3 were successfully closed, 3 are awaiting closure, and 1 had complete anastomotic failure requiring permanent diversion. Total failure rate was 10.3 per cent; contributing factors included prior radiation and ultra-low anastomoses.
 ...
PMID:Hartmann's colostomy reversal: outcome of patients undergoing surgery with the intention of eliminating fecal diversion. 1767 37


<< Previous 1 2 3 4 Next >>