Medicine › Surgery

Diverticular Disease and Complications

Works Count: 49218

Wikipedia

Description

This cluster of papers focuses on the diagnosis, treatment, and management of diverticulitis, with an emphasis on acute complications such as perforation and abscess formation. It covers various surgical approaches including primary anastomosis and Hartmann's procedure, as well as the use of laparoscopic lavage. Additionally, the cluster explores the epidemiology and long-term outcomes of diverticular disease.

Keywords

Diverticulitis; Treatment; Colonic Diverticulitis; Sigmoid Diverticulitis; Acute Complications; Perforated Diverticulitis; Primary Anastomosis; Hartmann's Procedure; Laparoscopic Lavage; Epidemiology

Diverticulitis

2007-11-14

Danny O. Jacobs

A previously healthy 45-year-old man presents with severe lower abdominal pain on the left side, which started 36 hours earlier. He has noticed mild discomfort in this region periodically before … A previously healthy 45-year-old man presents with severe lower abdominal pain on the left side, which started 36 hours earlier. He has noticed mild discomfort in this region periodically before but has not sought medical treatment. He reports nausea, anorexia, and vomiting associated with any oral intake. On physical examination, his temperature is 38.5°C and his heart rate is 110 beats per minute. He has abdominal tenderness on the left side without peritoneal signs. How should his case be managed?

Bailey & Scott's diagnostic microbiology

2007-01-01

Daniel F. Sahm Betty A. Forbes , photography by Ernest A. Trevino.

Bailey & Scott's diagnostic microbiology , Bailey & Scott's diagnostic microbiology , کتابخانه دیجیتالی دانشگاه علوم پزشکی و خدمات درمانی شهید بهشتی Bailey & Scott's diagnostic microbiology , Bailey & Scott's diagnostic microbiology , کتابخانه دیجیتالی دانشگاه علوم پزشکی و خدمات درمانی شهید بهشتی

Blaustein’s Pathology of the Female Genital Tract

2010-12-30

Robert J. Kurman , Lora Hedrick Ellenson , Brigitte M. Ronnett

Simplified assessment of segmental colonic transit

1987-01-01

Amanda M. Metcalf , Sidney F. Phillips , Alan R. Zinsmeister +3 more

Diagnosis and treatment of diverticular disease

1999-04-01

E. Köhler , Stefan Sauerland , E. Neugebauer +7 more

Statistics Notes: Interaction revisited: the difference between two estimates

2003-01-23

Douglas G. Altman

Spontaneous basal rectal activity, recorded after resection of the sigmoid colon for diverticular disease, was more than twice the normal. The rectum of post-resection cases yielded a markedly exaggerated overall … Spontaneous basal rectal activity, recorded after resection of the sigmoid colon for diverticular disease, was more than twice the normal. The rectum of post-resection cases yielded a markedly exaggerated overall response to prostigmine, in addition to producing abundant fast wave patterns. The response to stretch of the apparently normal colonic muscle remaining after resection of the sigmoid for diverticular disease resembled unresected diverticular segments, though less in degree, suggesting that a fundamental disorder of colonic muscle may be involved in the aetiology of colonic diverticula.

View PDF Chat

Objectivized diagnosis of acute pelvic inflammatory disease

1969-12-01

Lennart Jacobson , L Weström

Diet, nutrition, and cancer

1976-09-01

EN Alcantara , EW Speckmann

Blaustein's Pathology of the Female Genital Tract

2002-01-01

Pedro Grases

<i>Fusobacterium</i> in Colonic Flora and Molecular Features of Colorectal Carcinoma

2014-01-03

Tomomitsu Tahara , Eiichiro Yamamoto , Hiromu Suzuki +7 more

Abstract Fusobacterium species are part of the gut microbiome in humans. Recent studies have identified overrepresentation of Fusobacterium in colorectal cancer tissues, but it is not yet clear whether this … Abstract Fusobacterium species are part of the gut microbiome in humans. Recent studies have identified overrepresentation of Fusobacterium in colorectal cancer tissues, but it is not yet clear whether this is pathogenic or simply an epiphenomenon. In this study, we evaluated the relationship between Fusobacterium status and molecular features in colorectal cancers through quantitative real-time PCR in 149 colorectal cancer tissues, 89 adjacent normal appearing mucosae and 72 colonic mucosae from cancer-free individuals. Results were correlated with CpG island methylator phenotype (CIMP) status, microsatellite instability (MSI), and mutations in BRAF, KRAS, TP53, CHD7, and CHD8. Whole-exome capture sequencing data were also available in 11 cases. Fusobacterium was detectable in 111 of 149 (74%) colorectal cancer tissues and heavily enriched in 9% (14/149) of the cases. As expected, Fusobacterium was also detected in normal appearing mucosae from both cancer and cancer-free individuals, but the amount of bacteria was much lower compared with colorectal cancer tissues (a mean of 250-fold lower for Pan-fusobacterium). We found the Fusobacterium-high colorectal cancer group (FB-high) to be associated with CIMP positivity (P = 0.001), TP53 wild-type (P = 0.015), hMLH1 methylation positivity (P = 0.0028), MSI (P = 0.018), and CHD7/8 mutation positivity (P = 0.002). Among the 11 cases where whole-exome sequencing data were available, two that were FB-high cases also had the highest number of somatic mutations (a mean of 736 per case in FB-high vs. 225 per case in all others). Taken together, our findings show that Fusobacterium enrichment is associated with specific molecular subsets of colorectal cancers, offering support for a pathogenic role in colorectal cancer for this gut microbiome component. Cancer Res; 74(5); 1311–8. ©2014 AACR.

View PDF Chat

Diverticulitis in the United States: 1998–2005

2009-01-28

David A. Etzioni , Thomas M. Mack , Robert W. Beart +1 more

Diverticular disease imposes an impressive clinical burden to the United States population, with over 300,000 admissions and 1.5 million days of inpatient care annually. Consensus regarding the treatment of diverticulitis … Diverticular disease imposes an impressive clinical burden to the United States population, with over 300,000 admissions and 1.5 million days of inpatient care annually. Consensus regarding the treatment of diverticulitis has evolved over time, with increasing advocacy of primary anastomosis for acute diverticulitis, and nonoperative treatment of recurrent mild/moderate diverticulitis. We analyzed whether these changes are reflected in patterns of practice in a nationally-representative patient cohort.We used the 1998 to 2005 nationwide inpatient sample to analyze the care received by 267,000 patients admitted with acute diverticulitis, and 33,500 patients operated electively for diverticulitis. Census data were used to calculate population-based incidence rates of disease and surgical treatment. Weighted logistic regression with cluster adjustment at the hospital level was used for hypothesis testing.Overall annual age-adjusted admissions for acute diverticulitis increased from 120,500 in 1998 to 151,900 in 2005 (26% increase). Rates of admission increased more rapidly within patients aged 18 to 44 years (82%) and 45 to 74 years (36%). Elective operations for diverticulitis rose from 16,100 to 22,500 per year during the same time period (29%), also with a more rapid increase (73%) in rates of surgery for individuals aged 18 to 44 years. Multivariate analysis found no evidence that primary anastomosis is becoming more commonly used.We are the first to report dramatic changes in rates of treatment for diverticulitis in the United States. The causes of this emerging disease pattern are unknown, but certainly deserve further investigation. For patients undergoing surgery for acute diverticulitis, there was little change over time in the likelihood of a primary anastomosis.

Factors Contributing to Leakage of Colonic Anastomoses

1973-05-01

Theodore R. Schrock , Clifford W. Deveney , ENCLEBERT DUNPHY

SCHROCK, THEODORE R. M.D.; DEVENEY, CLIFFORD W. M.D; DUNPHY, ENCLEBERT M.D. Author Information SCHROCK, THEODORE R. M.D.; DEVENEY, CLIFFORD W. M.D; DUNPHY, ENCLEBERT M.D. Author Information

Natural history of diverticular disease of the colon. A review of 521 cases

1969-12-13

T G Parks

In a survey of the natural history of 521 patients with diverticular disease of the colon half of the patients had had symptoms for less than one month on presentation … In a survey of the natural history of 521 patients with diverticular disease of the colon half of the patients had had symptoms for less than one month on presentation at hospital, and these carried the highest morbidity and mortality. Progression of the disease was usually within segments initially involved, and extension to other regions of the colon rarely occurred. The overall prognosis of patients with total colonic involvement was similar to those with localized disease, while the morbidity and mortality associated with a recurrent attack were higher than in the initial acute episode.

View PDF Chat

ACRODERMATITIS ENTEROPATHICA: A LETHAL INHERITED HUMAN ZINC-DEFICIENCY DISORDER

1974-08-01

E J Moynahan

Diverticular disease of the colon: a deficiency disease of Western civilization.

1971-05-22

Neil S. Painter , D. P. Burkitt

We present a hypothesis as to the cause of diverticulosis coli which is consistent with its geographical distribution, its recent emergence as a medical problem, and its changing incidence.Diverticulosis appears … We present a hypothesis as to the cause of diverticulosis coli which is consistent with its geographical distribution, its recent emergence as a medical problem, and its changing incidence.Diverticulosis appears to be a deficiency disease caused by the refining of carbohydrates which entails the removal of vegetable fibre from the diet.Consequently we consider it to be prevent- able.Diverticulitis first became a clinical problem at the turn of the century, and the term "diverticulosis" first appeared in 1914.As recently as 1916 the disease was not important enough to merit a mention in textbooks.'Though the present incidence of diverticulosis is unknown it is certainly endemic in our aged citizens.This dramatic increase in incidence occurred in only 70 years and cannot possibly be explained on a genetic basis.This change might be due to observer error and be apparent rather than real, but we believe that their writings show that the clinicians of the last century were just as capable as those of today of recognizing diverti- culitis.We believe that there is another possibility-namely, that the colon's environment has changed and that diverticula are caused by the diet of so-called "civilized" countries.Historical Impact of Diverticular Disease on Medicine DIVERTICULA AS A CURIOSITY The term "divertikel" was used by Fleischman in 1815.2Gross in 1845,3 Cruveilhier in 1849,4 Rokitansky in 1849,5 Haberschon in 1857,6 and Klebs in 18697 realized that diverti- cula were acquired and thought they were caused by consti- pation.The danger of diverticula as sites of infection and perforation was pointed out by Cruveithier;4 in 1859 Sidney Jones described vesicocolic fistula due to diverticulitis.8Harrison Cripps in 1888 collected 63 enterovesical fistulae but believed that they were caused by ingested foreign bodies.'He emphasized that they were usually the result of "inflammatory mischief" and not of cancer, but he blamed only diverticulitis in the case of Jones.Virchow in 1853 described perisigmoiditis,l" while Loomis in 1870 recorded peritonitis resulting from diverticulitis."1Since this complication was still regarded as a surgical curiosity 30

View PDF Chat

The natural history of fistulizing Crohn's disease in Olmsted County, Minnesota

2002-04-01

David A. Schwartz , Edward V. Loftus , William J. Tremaine +4 more

View PDF Chat

EFFECT OF DIETARY FIBRE ON STOOLS AND TRANSIT-TIMES, AND ITS ROLE IN THE CAUSATION OF DISEASE

1972-12-01

D. P. Burkitt , Alexander Walker , Neil S. Painter

Postmortem survey of diverticular disease of the colon. I. Diverticulosis and diverticulitis.

1969-05-01

L E Hughes

Part I Diverticulosis and diverticulitisDiverticular disease of the colon is a common cause of morbidity among many western races, and, being especially a disease of the elderly, is becoming a … Part I Diverticulosis and diverticulitisDiverticular disease of the colon is a common cause of morbidity among many western races, and, being especially a disease of the elderly, is becoming a problem of increasing magnitude.Abdominal symptoms are common in this age group, and in the absence of evidence of other disease, the finding of diverticula on x-ray examination is prone to lead to a diagnosis of 'diverticulitis'.The frequency with which such an association is a chance one, without causal relationship, would depend on the incidence of diverticulosis in the normal population.It is probable that the present safety of colonic surgery is the major reason for a tendency to treat diverticular disease by resection at an early stage, for there has been little work reported on the natural history of the disease when treated con- servatively to prove that routine surgical excision is justified.The work which has been reported suggests that the disease is not as inexorable in its progress to serious complications as much surgical literature implies (Bolt and Hughes, 1966; Horner, 1958).Detailed studies of the pathology of diverticular disease are also surprisingly few, considering its importance as a cause of morbidity, while very little indeed is known of its aetiology.Deficiences in knowledge of aetiology and basic pathology make rational treatment difficult.This, together with the tendency to frequent diagnosis and radical therapy, may readily lead to overtreatment.This work has been carried out to determine the incidence of diverticula and associated pathology in Queensland, to attempt to assess the relationship of diverticula to symptoms, and to seek any evidence which may throw light on the aetiology of this condition. MATERIALS AND METHODSeach of 100 consecutive colons, the first taken during winter and the second during summer.The colons in this series were fixed in the undistended state, and all personally examined 24 to 48 hours after fixation.The mesentery and associated fat was dissected from the left colon, and the bowel carefully examined from internal and external aspects for the presence of diver- ticula.In this way small diverticula 2 to 3 mm in diameter were readily found.The colon and pericolic tissues were carefully examined for signs of recent or old infection, and sections were taken from such areas for histological study.Among details routinely recorded during necropsies at this hospital are the presence or absence of gallstones, an assessment of the degree of atheroma of the aorta, and the thickness of the subcutaneous fat at the umbilicus.These details were taken from the postmortem records for correlation with the presence of diverti- cula.The clinical records of all patients were studied to determine the cause of death and the presence of coexistent disease, including hypertension, and the presence of bowel symptoms at the time of admission or as recorded in the past history.INCIDENCE AND RESULTS INCIDENCE OF DIVERTICULA IN THE COLON Diverticula were found in 90 of the 200 colons (Table I).TABLE I

View PDF Chat

The Blood Groups in Relation to Peptic Ulceration and Carcinoma of Colon, Rectum, Breast, and Bronchus

1954-08-07

Ian Aird , H. H. Bentall , J. A. Mehigan +1 more

We have previously shown an association between the ABO blood groups and cancer of the stomach, group A being significantly commoner in patients suffering from cancer of the stomach than … We have previously shown an association between the ABO blood groups and cancer of the stomach, group A being significantly commoner in patients suffering from cancer of the stomach than in controls drawn from the same hospitals (Aird, Bentall, and Roberts, 1953).The further diseases for which fairly large numbers have so far been obtained are peptic ulceration and carcinoma of the colon, rectum, breast, and bronchus.The results are presented in this paper, which also includes some data on Rhesus grouping.In addition, further calculations have been made on the figures for cancer of the stomach already published.A detailed examination of our data follows.The results have proved remarkably clear-cut: blood group 0 is strikingly high and the other three groups correspondingly low in patients suffering from peptic ulcer.The three cancers now studied, unlike cancer of the stomach, showed no significant blood-group association. Collection of DataThe survey was carried out at 12 hospitals in England, and covers cases treated during the years 1948-53.At the first hospital visited, St. Mark's, London, cases from 1946 were included, but, as the blood groups were not often recorded in the earlier years, surveys in hospitals subsequently visited were restricted to 1948-53.It was also felt that during this period blood-grouping tech- niques were uniform and reliable.In such a study it was imperative to have rigid criteria of diagnosis in each disease.For the carcinomas, only cases proved by histological report on material obtained by biopsy, operation, or post-mortem examination were accepted.In peptic ulceration the criterion was a macroscopic report (operation or gastroscopy).The majority of these cases were perforated or bleeding ulcers or those submitted to elective surgery, for it is only in these cases that the blood group is often iecorded.Thus our series does not include many medically treated cases and therefore is not representa-

View PDF Chat

Practice Parameters for Sigmoid Diverticulitis

2006-06-01

Janice F. Rafferty , Paul C. Shellito , Neil Hyman +1 more

Rafferty, Janice M.D.; Shellito, Paul M.D.; Hyman, Neil H. M.D.; Buie, W. Donald M.D. and the Standards Committee of The American Society of Colon and Rectal Surgeons Author Information Rafferty, Janice M.D.; Shellito, Paul M.D.; Hyman, Neil H. M.D.; Buie, W. Donald M.D. and the Standards Committee of The American Society of Colon and Rectal Surgeons Author Information

Long-term Risk of Acute Diverticulitis Among Patients With Incidental Diverticulosis Found During Colonoscopy

2013-07-12

Kamyar Shahedi , Garth Fuller , Roger Bolus +7 more

View PDF Chat

Long-Term Functional Outcome and Quality of Life After Stapled Restorative Proctocolectomy

1999-10-01

Victor W. Fazio , M. G. O’Ríordáin , Ian C. Lavery +4 more

Objective To evaluate prospectively long-term quality of life and functional outcome after restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis, and to evaluate and validate a novel quality-of-life indicator in this … Objective To evaluate prospectively long-term quality of life and functional outcome after restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis, and to evaluate and validate a novel quality-of-life indicator in this group of patients. Summary Background Data Restorative proctocolectomy with ileal pouch-anal anastomosis is now the preferred option when total proctocolectomy is required for ulcerative colitis or familial adenomatous polyposis, but long-term data on functional outcome and quality of life after the procedure are lacking. Methods Patients (n = 977) who underwent RPC with stapled anastomosis for colitis or polyposis coli and who were followed for ≥12 months were included. Quality of life, fecal incontinence, and satisfaction with surgery were prospectively evaluated by structured interview or questionnaire for 1 to 12 years after surgery (median 5.0). Quality of life was scored using the Cleveland Global Quality of Life (CGQL) instrument (Fazio Score). This is a novel score developed over the past 15 years by the senior author. Quality of life was also evaluated in a subgroup of patients with the Short Form 36 (SF-36). The CGQL was validated by determining its reliability, responsiveness, and validity as well as its correlation with the SF-36 score. Results Postoperative quality of life as measured by SF-36 was excellent and compared well with published norms for the general U.S. population. The CGQL was found to be reliable, responsive, and valid, and there was a high correlation with the SF-36 scores. Using the CGQL, quality of life was shown to increase after the first 2 years after surgery, and there was no deterioration thereafter. The prevalence of perfect continence increased from 75.5% before surgery to 82.4% after surgery, and although this deteriorated somewhat >2 years after surgery, it was no worse than preoperative values. Ninety-eight percent of patients would recommend the surgery to others. Conclusions Long-term quality of life after ileal pouch surgery is excellent and the level of continence is satisfactory. This surgery is an excellent long-term option in patients requiring total proctocolectomy. The CGQL is a simple, valid, and reliable measure of quality of life after pelvic pouch surgery and may well be applicable in many other clinical conditions.

Proctocolectomy without ileostomy for ulcerative colitis.

1978-07-08

A G Parks , R J Nicholls

An operation has been developed that permits total removal of all disease-prone mucosa in ulcerative colitis but avoids the need for a permanent ileostomy. The colon and upper half of … An operation has been developed that permits total removal of all disease-prone mucosa in ulcerative colitis but avoids the need for a permanent ileostomy. The colon and upper half of the rectum are excised and the remaining inflamed mucosa is stripped from the rectal stump down to the dentate line of the anal canal. A pouch is fashioned from a triplicated loop of terminal ileum. This is drawn down through the denuded rectum and an anastomosis created, via the per-anal approach, between the ileum just distal to the pouch and the mid-anal canal. A temporary ileostomy is made. Out of eight patients so treated, five were available for assessment, and four of them were highly satisfied with the result in improved health and function. The remaining three were awaiting closure of their ileostomies.

View PDF Chat

REGIONAL ILEITIS

1932-10-15

Burrill B. Crohn

We propose to describe, in its pathologic and clinical details, a disease of the terminal ileum, affecting mainly young adults, characterized by a subacute or chronic necrotizing and cicatrizing inflammation. … We propose to describe, in its pathologic and clinical details, a disease of the terminal ileum, affecting mainly young adults, characterized by a subacute or chronic necrotizing and cicatrizing inflammation. The ulceration of the mucosa is accompanied by a disproportionate connective tissue reaction of the remaining walls of the involved intestine, a process which frequently leads to stenosis of the lumen of the intestine, associated with the formation of multiple fistulas. The disease is clinically featured by symptoms that resemble those of ulcerative colitis, namely, fever, diarrhea and emaciation, leading eventually to an obstruction of the small intestine; the constant occurrence of a mass in the right iliac fossa usually requires surgical intervention (resection). The terminal ileum is alone involved. The process begins abruptly at and involves the ileocecal valve in its maximal intensity, tapering off gradually as it ascends the ileum orally for from 8 to 12 inches (20

Practice parameters for the treatment of sigmoid diverticulitis—Supporting documentation

2000-03-01

Douglas W. Wong , Steven D. Wexner , Ann C. Lowry +7 more

It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same … It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

Towards positive diagnosis of the irritable bowel.

1978-09-02

A P Manning , Wade Thompson , K W Heaton +1 more

A questionnaire to establish the presence of 15 symptoms thought to be typical of the irritable bowel syndrome (IBS) was given to 109 unselected patients referred to gastroenterology or surgery … A questionnaire to establish the presence of 15 symptoms thought to be typical of the irritable bowel syndrome (IBS) was given to 109 unselected patients referred to gastroenterology or surgery clinics with abdominal pain or a change in bowel habit or both. Review of case records 17--26 months later established a definite diagnosis of IBS in 32 patients and of organic disease in 33. Four symptoms were significantly more common among patients with IBS--namely, distension, relief of pain with bowel movement, and looser and more frequent bowel movements with the onset of pain. Mucus and a sensation of incomplete evacuation were also common in these patients. The more of these symptoms that were present the more likely was it that the patient's pain or altered bowel habit, or both, was due to IBS. We conclude that a careful history can increase diagnostic confidence and reduce the amount of investigation in many patients with chronic abdominal pain.

View PDF Chat

Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis13

2012-01-30

Abbas Chabok , Lars Påhlman , Fredrik Hjern +2 more

Abstract Background The standard of care for acute uncomplicated diverticulitis today is antibiotic treatment, although there are no controlled studies supporting this management. The aim was to investigate the need … Abstract Background The standard of care for acute uncomplicated diverticulitis today is antibiotic treatment, although there are no controlled studies supporting this management. The aim was to investigate the need for antibiotic treatment in acute uncomplicated diverticulitis, with the endpoint of recovery without complications after 12 months of follow-up. Methods This multicentre randomized trial involving ten surgical departments in Sweden and one in Iceland recruited 623 patients with computed tomography-verified acute uncomplicated left-sided diverticulitis. Patients were randomized to treatment with (314 patients) or without (309 patients) antibiotics. Results Age, sex, body mass index, co-morbidities, body temperature, white blood cell count and C-reactive protein level on admission were similar in the two groups. Complications such as perforation or abscess formation were found in six patients (1·9 per cent) who received no antibiotics and in three (1·0 per cent) who were treated with antibiotics (P = 0·302). The median hospital stay was 3 days in both groups. Recurrent diverticulitis necessitating readmission to hospital at the 1-year follow-up was similar in the two groups (16 per cent, P = 0·881). Conclusion Antibiotic treatment for acute uncomplicated diverticulitis neither accelerates recovery nor prevents complications or recurrence. It should be reserved for the treatment of complicated diverticulitis. Registration number: NCT01008488 (http://www.clinicaltrials.gov).

View PDF Chat

The Management of Complicated Diverticulitis and the Role of Computed Tomography

2005-03-18

Andreas M. Kaiser , Jeng-Kae Jiang , J P Lake +5 more

PURPOSE Acute diverticulitis is a disease with a wide clinical spectrum, ranging from a phlegmon (stage Ia), to localized abscesses (stages Ib and II), to free perforation with purulent (stage … PURPOSE Acute diverticulitis is a disease with a wide clinical spectrum, ranging from a phlegmon (stage Ia), to localized abscesses (stages Ib and II), to free perforation with purulent (stage III) or feculent peritonitis (stage IV). While there is little debate about the best treatment for mild episodes and/or very severe episodes, uncertainty persists about the optimal management for intermediate stages (Ib and II). The aim of our study was therefore to define the role of computed tomography (CT) and to analyze its impact on the management of acute diverticulitis. METHODS We retrospectively analyzed 511 patients (296 males, 215 females) admitted for acute diverticulitis between January 1994 and December 2003. Excluded were patients with stoma reversal only, "diverticulitis" mimicked by cancer, or significantly deficient patient records. Patients were analyzed either as a whole or subgrouped according to age (<40 yr, >40 yr). A modified Hinchey classification was used to stage the severity of acute diverticulitis. RESULTS In 99 patients (19.4%), an abscess was found (74 pericolic, 25 pelvic, median diameter: 4.0 cm). CT-guided drainage was performed in 16 patients, one failure requiring a two-stage operation. Whereas conservative treatment failed in 6.8% in patients without abscess or perforation, 22.2% of patients with an abscess required an urgent resection (68.2%, one-stage, 31.8%, two-stage). Recurrence rates were 13% for mild cases, as compared to 41.2% in patients with a pelvic abscess (stage II) treated conservatively with/without CT-guided drainage. Of all surgical cases, resection/primary anastomosis was achieved in 73.6% with perioperative mortality of 1.1% and leak rate was 2.1%. CONCLUSIONS CT evidence of a diverticular abscess has a prognostic impact as it correlates with a high risk of failure from nonoperative management regardless of the patient's age. After treatment of diverticulitis with CT evidence of an abscess, physicians should strongly consider elective surgery in order to prevent recurrent diverticulitis.

AGA technical review on perianal Crohn’s disease

2003-11-01

William J. Sandborn , Victor W. Fazio , Brian G. Feagan +1 more

Mechanism of action of dietary fibre in the human colon

1980-03-01

Alison M. Stephen , John H. Cummings

Polyps and cancer of the large bowel: a necropsy study in Liverpool.

1982-10-01

A. Williams , B.A.W. Balasooriya , D W Day

In a prospective necropsy study of the large bowel in 365 cases, the commonest polyp identified was the hyperplastic (metaplastic) variety, of which 86.1% of the total were located in … In a prospective necropsy study of the large bowel in 365 cases, the commonest polyp identified was the hyperplastic (metaplastic) variety, of which 86.1% of the total were located in the rectum. The other main type of polyp found, and of much greater importance because of its malignant potential, was the neoplastic adenoma. These were present, either singly or multiply, in 73 of 198 male cases (36.9%) and in 48 of 167 female cases (28.7%). Their prevalence and their tendency to be multiple rose with increasing age in both sexes. Most adenomas had a tubular growth pattern and 88.8% of these were under 1 cm in diameter. There was a fairly even distribution of adenomas throughout the large bowel but a higher proportion of adenomas over 1 cm in diameter occurred in the caecum, sigmoid colon, and rectum than at other sites. In the whole series nine adenocarcinomas were present, two of which were arising in adenomas.

View PDF Chat

Our new president—Jon I. Isenberg, M.D

2001-05-01

C. Richard Boland , Tadataka Yamada

Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice

2011-06-27

Clarence C. Tam , Laura C. Rodrigues , Laura Viviani +7 more

<h3>Objectives</h3> To estimate, overall and by organism, the incidence of infectious intestinal disease (IID) in the community, presenting to general practice (GP) and reported to national surveillance. <h3>Design</h3> Prospective, community … <h3>Objectives</h3> To estimate, overall and by organism, the incidence of infectious intestinal disease (IID) in the community, presenting to general practice (GP) and reported to national surveillance. <h3>Design</h3> Prospective, community cohort study and prospective study of GP presentation conducted between April 2008 and August 2009. <h3>Setting</h3> Eighty-eight GPs across the UK recruited from the Medical Research Council General Practice Research Framework and the Primary Care Research Networks. <h3>Participants</h3> 6836 participants registered with the 88 participating practices in the community study; 991 patients with UK-acquired IID presenting to one of 37 practices taking part in the GP presentation study. <h3>Main outcome measures</h3> IID rates in the community, presenting to GP and reported to national surveillance, overall and by organism; annual IID cases and GP consultations by organism. <h3>Results</h3> The overall rate of IID in the community was 274 cases per 1000 person-years (95% CI 254 to 296); the rate of GP consultations was 17.7 per 1000 person-years (95% CI 14.4 to 21.8). There were 147 community cases and 10 GP consultations for every case reported to national surveillance. Norovirus was the most common organism, with incidence rates of 47 community cases per 1000 person-years and 2.1 GP consultations per 1000 person-years. <i>Campylobacter</i> was the most common bacterial pathogen, with a rate of 9.3 cases per 1000 person-years in the community, and 1.3 GP consultations per 1000 person-years. We estimate that there are up to 17 million sporadic, community cases of IID and 1 million GP consultations annually in the UK. Of these, norovirus accounts for 3 million cases and 130 000 GP consultations, and <i>Campylobacter</i> is responsible for 500 000 cases and 80 000 GP consultations. <h3>Conclusions</h3> IID poses a substantial community and healthcare burden in the UK. Control efforts must focus particularly on reducing the burden due to <i>Campylobacter</i> and enteric viruses.

View PDF Chat

CT Enterography as a Diagnostic Tool in Evaluating Small Bowel Disorders: Review of Clinical Experience with over 700 Cases

2006-05-01

S Paulsen , James E. Huprich , Joel G. Fletcher +6 more

Computed tomographic (CT) enterography combines the improved spatial and temporal resolution of multi–detector row CT with large volumes of ingested neutral enteric contrast material to permit visualization of the small … Computed tomographic (CT) enterography combines the improved spatial and temporal resolution of multi–detector row CT with large volumes of ingested neutral enteric contrast material to permit visualization of the small bowel wall and lumen. Adequate luminal distention can usually be achieved with oral hyperhydration, thereby obviating nasoenteric intubation and making CT enterography a useful, well-tolerated study for the evaluation of diseases affecting the mucosa and bowel wall. Unlike routine CT, which has been used to detect the extraenteric complications of Crohn disease such as fistula and abscess, CT enterography clearly depicts the small bowel inflammation associated with Crohn disease by displaying mural hyperenhancement, stratification, and thickening; engorged vasa recta; and perienteric inflammatory changes. As a result, CT enterography is becoming the first-line modality for the evaluation of suspected inflammatory bowel disease. CT enterography has also become an important alternative to traditional fluoroscopy in the assessment of other small bowel disorders such as celiac sprue and small bowel neoplasms. © RSNA, 2006

Guidelines of Diagnostics and Treatment of Acute Left-Sided Colonic Diverticulitis

2013-01-01

Caroline S. Andeweg , Irene M. Mulder , R. J. F. Felt‐Bersma +7 more

This prospective study was done to compare acute left-sided colonic diverticulitis in young patients (50 years of age or less) and older patients (more than 50 years of age) for … This prospective study was done to compare acute left-sided colonic diverticulitis in young patients (50 years of age or less) and older patients (more than 50 years of age) for severity of disease and immediate and late outcome.Of the 265 patients studied, 61 were 50 years of age or less; of these, 49 were men. In all instances, diagnosis was confirmed radiologically or histologically.Operations were performed less often upon younger patients than older patients (15 versus 33 percent, p = 0.001). Severe diverticulitis was found more often in younger men than older men (39 versus 23 percent). After successful conservative treatment during the first hospitalization period, younger men had a statistically greater risk of poor outcome than older men (29 versus 5 percent, p = 0.003).Although younger men have severe acute diverticulitis more often than older men, operative treatment during the first episode is less often needed. On the other hand, after conservative treatment, younger men have a statistically greater chance of poor secondary outcome than older men.

View PDF Chat

Diverticular Disease of the Colon

2010-01-01

J. M. Fox , Neil Stollman

Dietary Fiber and Disease

1974-08-19

D. P. Burkitt

Many diseases common in and characteristic of modern western civilization have been shown to be related to the amount of time necessary for the passage of intestinal content through the … Many diseases common in and characteristic of modern western civilization have been shown to be related to the amount of time necessary for the passage of intestinal content through the alimentary tract, and to the bulk and consistency of stools. These factors have in turn been shown to be greatly influenced by the fiber content of the diet and by the amount of cereal fiber in particular. Mechanisms are postulated whereby these changes in gastrointestinal behavior could in part explain the occurrence of such common disorders as ischemic heart disease, appendicitis, diverticular disease, gallbladder disease, varicose veins, deep vein thrombosis, hiatus hernia, and tumors of the large bowel. Calorie intake, speed of passage through the intestine, levels of intracolonic pressures, number and type fecal bacteria, as well as levels of serum cholesterol and changes in bile-salt metabolism have all been shown to be related to the amount of dietary fiber consumed. (<i>JAMA</i>229:1068-1074, 1974)

PULMONARY INSUFFICIENCY

1948-09-01

Eleanor DeF. Baldwin , André Cournand , Dickinson W. Richards

deF. BALDWIN, ELEANOR M.D.; COURNAND, ANDRE M.D.; RICHARDS, DICKINSON W. Jr. M.D. Author Information deF. BALDWIN, ELEANOR M.D.; COURNAND, ANDRE M.D.; RICHARDS, DICKINSON W. Jr. M.D. Author Information

Acute appendicitis is characterised by local invasion with Fusobacterium nucleatum/necrophorum

2009-11-18

Alexander Swidsinski , Yvonne Dörffel , Vera Loening‐Baucke +7 more

Acute appendicitis is a local intestinal inflammation with unclear origin. The aim was to test whether bacteria in appendicitis differ in composition to bacteria found in caecal biopsies from healthy … Acute appendicitis is a local intestinal inflammation with unclear origin. The aim was to test whether bacteria in appendicitis differ in composition to bacteria found in caecal biopsies from healthy and disease controls.We investigated sections of 70 appendices using rRNA-based fluorescence in situ hybridisation. Four hundred caecal biopsies and 400 faecal samples from patients with inflammatory bowel disease and other conditions were used as controls. A set of 73 group-specific bacterial probes was applied for the study.The mucosal surface in catarrhal appendicitis showed characteristic lesions of single epithelial cells filled with a mixed bacterial population ('pinned cells') without ulceration of the surroundings. Bacteria deeply infiltrated the tissue in suppurative appendicitis. Fusobacteria (mainly Fusobacterium nucleatum and necrophorum) were a specific component of these epithelial and submucosal infiltrates in 62% of patients with proven appendicitis. The presence of Fusobacteria in mucosal lesions correlated positively with the severity of the appendicitis and was completely absent in caecal biopsies from healthy and disease controls. Main faecal microbiota represented by Bacteroides, Eubacterium rectale (Clostridium group XIVa), Faecalibacterium prausnitzii groups and Akkermansia muciniphila were inversely related to the severity of the disease. The occurrence of other bacterial groups within mucosal lesions of acute appendicitis was not related to the severity of the appendicitis. No Fusobacteria were found in rectal swabs of patients with acute appendicitis.Local infection with Fusobacterium nucleatum/necrophorum is responsible for the majority of cases of acute appendicitis.

Treatment of perforated diverticular disease of the colon.

1978-01-01

Hinchey Ej , Schaal Pg , Richards Gk

Bilateral Ureteral Obstruction due to Envelopment and Compression by an Inflammatory Retroperitoneal Process

1948-06-01

John K. Ormond

No AccessJournal of Urology1 Jun 1948Bilateral Ureteral Obstruction due to Envelopment and Compression by an Inflammatory Retroperitoneal Process John K. Ormond John K. OrmondJohn K. Ormond More articles by this … No AccessJournal of Urology1 Jun 1948Bilateral Ureteral Obstruction due to Envelopment and Compression by an Inflammatory Retroperitoneal Process John K. Ormond John K. OrmondJohn K. Ormond More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)69482-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1948 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byDay K, Nikolaidis P and Casalino D (2012) Retroperitoneal FibrosisJournal of Urology, VOL. 187, NO. 4, (1440-1441), Online publication date: 1-Apr-2012.Brandt A, Kamper L, Kukuk S, Haage P and Roth S (2018) Associated Findings and Complications of Retroperitoneal Fibrosis in 204 Patients: Results of a Urological RegistryJournal of Urology, VOL. 185, NO. 2, (526-531), Online publication date: 1-Feb-2011.Srinivasan A, Richstone L, Permpongkosol S and Kavoussi L (2018) Comparison of Laparoscopic With Open Approach for Ureterolysis in Patients With Retroperitoneal FibrosisJournal of Urology, VOL. 179, NO. 5, (1875-1878), Online publication date: 1-May-2008.Kardar A, Kattan S, Lindstedt E and Hanash K (2018) Steroid Therapy For Idiopathic Retroperitoneal Fibrosis: Dose And DurationJournal of Urology, VOL. 168, NO. 2, (550-555), Online publication date: 1-Aug-2002.SPEZIALE F, SBARIGIA E, GROSSI R, MARAGLINO C and FIORANI P (2018) INFLAMMATORY ANEURYSMS OF THE ABDOMINAL AORTA INVOLVING THE URETERS: IS COMBINED TREATMENT REALLY NECESSARY?Journal of Urology, VOL. 165, NO. 1, (27-31), Online publication date: 1-Jan-2001.Nishimura T, Terashima Y, Kondo Y, Ohba S, Yoshida K and Akimoto M (2018) Long-Term Indwelling Bilateral Ureteral Stents for Bilateral Hydronephrosis of Unknown EtiologyJournal of Urology, VOL. 149, NO. 1, (96-99), Online publication date: 1-Jan-1993.Moul J (2018) Retroperitoneal Fibrosis Following Radiotherapy for Stage I Testicular SeminomaJournal of Urology, VOL. 147, NO. 1, (124-126), Online publication date: 1-Jan-1992.Waters V (2018) Hydralazine, Hydrochlorothiazide and Ampicillin Associated with Retroperitoneal Fibrosis: Case ReportJournal of Urology, VOL. 141, NO. 4, (936-937), Online publication date: 1-Apr-1989.Reiner I, Yachia (Yahya) D, Nissim F and Fishelowitz Y (2018) Retroperitoneal Fibrosis in Association with Urothelial TumorJournal of Urology, VOL. 132, NO. 1, (115-116), Online publication date: 1-Jul-1984.Finan B and Finkbeiner A (2018) Renal Papillary Necrosis and Retroperitoneal Fibrosis Secondary to Analgesic AbuseJournal of Urology, VOL. 126, NO. 4, (533-534), Online publication date: 1-Oct-1981.Lepor H and Walshi P (2018) Idiopathic Retroperitoneal FibrosisJournal of Urology, VOL. 122, NO. 1, (1-6), Online publication date: 1-Jul-1979.Zabetakis P, Novich R, Matarese R and Michelis M (2018) Idiopathic Retroperitoneal Fibrosis: A Systemicconnective Tissue Disease?Journal of Urology, VOL. 122, NO. 1, (100-102), Online publication date: 1-Jul-1979.Droller M (2018) Editorial CommentJournal of Urology, VOL. 122, NO. 1, (102-102), Online publication date: 1-Jul-1979.Pahira J, Wein A, Barker C, Banner M, Arger P, Mulhern C and Pollack H (2018) Bilateral Complete Ureteral Obstruction Secondary to an Abdominal Aortic Aneurysm with Perianeurysmal Fibrosis: Diagnosis by Computed TomographyJournal of Urology, VOL. 121, NO. 1, (103-106), Online publication date: 1-Jan-1979.Arriola P, El-droubi H and Dahlen C (2018) Combined Retrocaval Ureter and Retroperitoneal Fibrosis: Report of a CaseJournal of Urology, VOL. 121, NO. 1, (107-108), Online publication date: 1-Jan-1979.Moody T and Vaughan E (2018) Steroids in the Treatment of Retroperitoneal FibrosisJournal of Urology, VOL. 121, NO. 1, (109-111), Online publication date: 1-Jan-1979.Ross J and Prout G (2018) Retroperitoneal Fat Necrosis Producing Ureteral ObstructionJournal of Urology, VOL. 115, NO. 5, (524-529), Online publication date: 1-May-1976.Skeel D, Shols G, Sullivan M and Witherington R (2018) Retroperitoneal Fibrosis with Intrinsic Ureteral InvolvementJournal of Urology, VOL. 113, NO. 2, (166-169), Online publication date: 1-Feb-1975.Ochsner M, Brannan W, Pond H and Goodlet J (2018) Medical Therapy in Idiopathic Retroperitoneal FibrosisJournal of Urology, VOL. 114, NO. 5, (700-703), Online publication date: 1-Nov-1975.Stecker J, Rawls H, Devine C and Devine P (2018) Retroperitoneal Fibrosis and Ergot DerivativesJournal of Urology, VOL. 112, NO. 1, (30-32), Online publication date: 1-Jul-1974.Persky L and Huus J (2018) Atypical Manifestations of Retroperitoneal FibrosisJournal of Urology, VOL. 111, NO. 3, (340-344), Online publication date: 1-Mar-1974.Peck D, Bhatt G and Lowman R (2018) Traction Displacement of the Ureter: A Sign of Aortic AneurysmJournal of Urology, VOL. 109, NO. 6, (983-986), Online publication date: 1-Jun-1973.Abbott D, Skinner D, Yalowitz P and Mulder D (2018) Retroperitoneal Fibrosis Associated with Abdominal Aortic Aneurysms: An Approach to ManagementJournal of Urology, VOL. 109, NO. 6, (987-989), Online publication date: 1-Jun-1973.Cerny J and Scott T (2018) Non-Idiopathic Retroperitoneal FibrosisJournal of Urology, VOL. 105, NO. 1, (49-55), Online publication date: 1-Jan-1971.Amar A (2018) Ureteropyelostomy for Relief of Single Ureteral Obstruction Due to Retroperitoneal Fibrosis in a Patient with Ureteral DuplicationJournal of Urology, VOL. 103, NO. 3, (296-297), Online publication date: 1-Mar-1970.Wagenknecht L and Madsen P (2018) Bilateral Ureteral Obstruction Secondary to Aortic AneurysmJournal of Urology, VOL. 103, NO. 6, (732-736), Online publication date: 1-Jun-1970.Mulvaney W, Gordon L and Gritti E (2018) Another Look at Periureteral FibrosisJournal of Urology, VOL. 99, NO. 4, (417-422), Online publication date: 1-Apr-1968.Halverstadt D (2018) Problems in the Use of Urography and Lymphangiography in the Diagnosis of Idiopathic Retroperitoneal FibrosisJournal of Urology, VOL. 99, NO. 4, (423-426), Online publication date: 1-Apr-1968.Kerr W, Suby H, Vickery A and Fraley E (2018) Idiopathic Retroperitoneal Fibrosis: Clinical Experiences with 15 Cases, 1956–1967Journal of Urology, VOL. 99, NO. 5, (575-584), Online publication date: 1-May-1968.Catino D, Torack R and Hagstrom J (2018) Idiopathic Retroperitoneal Fibrosis: Histochemical Evidence for Lateral Spread of the Process from the MidlineJournal of Urology, VOL. 98, NO. 2, (191-194), Online publication date: 1-Aug-1967.Behrens M and Holland J (2018) Periureteritis Plastica: Report of a Case Following Staphylococcal InfectionJournal of Urology, VOL. 97, NO. 5, (829-839), Online publication date: 1-May-1967.Corriere J, Mackie J and Murphy J (2018) Retroperitoneal Fibrosis Presenting with Large Bowel Symptoms: Report of Two CasesJournal of Urology, VOL. 96, NO. 2, (161-166), Online publication date: 1-Aug-1966.Bookstein J, Schroeder K and Batsakis J (2018) Lymphangiography in the Diagnosis of Retroperitoneal Fibrosis: Case ReportJournal of Urology, VOL. 95, NO. 1, (99-101), Online publication date: 1-Jan-1966.Ormond J (2018) Idiopathic Retroperitoneal Fibrosis: A Discussion of the EtiologyJournal of Urology, VOL. 94, NO. 4, (385-390), Online publication date: 1-Oct-1965.Brown K, Staubitz W, Oberkircher O and Niesen W (2018) A Review of Retroperitoneal FibrosisJournal of Urology, VOL. 92, NO. 4, (323-330), Online publication date: 1-Oct-1964.Oppenheimer G and Goldman H (2018) Periureteral Fibrosis: An Unusual Complication of Renal BiopsyJournal of Urology, VOL. 88, NO. 5, (611-615), Online publication date: 1-Nov-1962.Kaufman J (2018) Unusual Causes of Extrinsic Ureteral Obstruction, Part IJournal of Urology, VOL. 87, NO. 3, (319-327), Online publication date: 1-Mar-1962.Kendall A and Lakey W (2018) Sclerosing Hodgkin’s Disease vs. Idiopathic Retroperitoneal FibrosisJournal of Urology, VOL. 86, NO. 2, (217-221), Online publication date: 1-Aug-1961.Hoffman W and Trippel O (2018) Retroperitoneal Fibrosis: Etiologic ConsiderationsJournal of Urology, VOL. 86, NO. 2, (222-231), Online publication date: 1-Aug-1961.Charnock D, Riddell H and Lombardo L (2018) Retroperitoneal Fibrosis Producing Ureteral ObstructionJournal of Urology, VOL. 85, NO. 3, (251-257), Online publication date: 1-Mar-1961.Samellas W (2018) Ureteral Obstruction due to Compression by an Idiopathic Retroperitoneal Inflammatory ProcessJournal of Urology, VOL. 85, NO. 6, (928-933), Online publication date: 1-Jun-1961.Hewett A and Headstream J (2018) Pericystitis PlasticaJournal of Urology, VOL. 83, NO. 2, (103-107), Online publication date: 1-Feb-1960.Shaheen D and Johnston A (2018) Bilateral Ureteral Obstruction Due to Envelopment and Compression by an Inflammatory Retroperitoneal Process: Report of two CasesJournal of Urology, VOL. 82, NO. 1, (51-57), Online publication date: 1-Jul-1959.Bates B (2018) Periureteritis Obliterans: A Case Report with a Review of the LiteratureJournal of Urology, VOL. 82, NO. 1, (58-61), Online publication date: 1-Jul-1959.Hutch J, Atkinson R and Loquvam G (2018) Perirenal (Gerota’s) FascitisJournal of Urology, VOL. 81, NO. 1, (76-95), Online publication date: 1-Jan-1959.Mulvaney W (2018) Periureteritis Obliterans: A Retroperitoneal Inflammatory DiseaseJournal of Urology, VOL. 79, NO. 3, (410-417), Online publication date: 1-Mar-1958.Noring O (2018) Nonspecific Ureteritis Elucidated by a Case of Primary UreteritisJournal of Urology, VOL. 79, NO. 4, (701-706), Online publication date: 1-Apr-1958.Talbot H and Mahoney E (2018) Obstruction of Both Ureters by Retroperitoneal InflammationJournal of Urology, VOL. 78, NO. 6, (738-747), Online publication date: 1-Dec-1957.Iozzi L and Murphy J (2018) Bilateral Ureteral Obstruction by Retroperitoneal InflammationJournal of Urology, VOL. 77, NO. 3, (402-406), Online publication date: 1-Mar-1957.Hejtmancik J and Magid M (2018) Bilateral Periureteritis PlasticaJournal of Urology, VOL. 76, NO. 1, (57-61), Online publication date: 1-Jul-1956.Benjamin J, Betheil J, Emmel V, Ramsey G and Watson J (2018) Observations on Ureteral Obstruction and Contractility in Man and DogJournal of Urology, VOL. 75, NO. 1, (25-42), Online publication date: 1-Jan-1956.Mirabile C and Spillane R (2018) Bilateral Ureteral Compression With Obstruction from a Nonspecific Retroperitoneal Inflammatory Process: Case ReportJournal of Urology, VOL. 73, NO. 5, (783-787), Online publication date: 1-May-1955.Chisholm E, Hutch J and Bolomey A (2018) Bilateral Ureteral Obstruction Due to Chronic Inflammation of the Fascia Around the UretersJournal of Urology, VOL. 72, NO. 5, (812-816), Online publication date: 1-Nov-1954.Bradfield E (2018) Bilateral Ureteral Obstruction due to Envelopment and Compression by an Inflammatory Retroperitoneal ProcessJournal of Urology, VOL. 69, NO. 6, (769-773), Online publication date: 1-Jun-1953.Miller J, Lipin R, Meisel H and Long P (2018) Bilateral Ureteral Obstruction due to Compression by Chronic Retroperitoneal InflammationJournal of Urology, VOL. 68, NO. 2, (447-451), Online publication date: 1-Aug-1952.Shivers C and Axilrod H (2018) Lymphoblastomatous NephropathyJournal of Urology, VOL. 65, NO. 3, (380-385), Online publication date: 1-Mar-1951. Volume 59Issue 6June 1948Page: 1072-1079 Advertisement Copyright & Permissions© 1948 by The American Urological Association Education and Research, Inc.MetricsAuthor Information John K. Ormond More articles by this author Expand All Advertisement PDF downloadLoading ...

[Natural history of diverticular disease of the colon].

1986-07-01

P Bernadès

Diverticular disease of the colon is frequent in developed countries, probably due to diets poor in fiber. Prevalence increases with age, reaching 65 percent at 70 years. The preferred seat … Diverticular disease of the colon is frequent in developed countries, probably due to diets poor in fiber. Prevalence increases with age, reaching 65 percent at 70 years. The preferred seat of the disease is the sigmoid colon. The disease is usually asymptomatic, but inflammatory signs are seen in 10 to 25 percent of cases. Diagnosis of diverticulitis is difficult since correlation between clinical signs and histological data is often mediocre. Surgery is carried out in 15 to 30 percent of patients presenting severe disorders, i.e. in 1 to 2 percent of the overall population presenting diverticulosis of the colon. The most efficacious method of preventing complications may be the implementation of a fiber-rich diet.

Practice parameters for the treatment of sigmoid diverticulitis

2000-03-01

Blaustein’s Pathology of the Female Genital Tract

1995-01-01

Bruce A. Warren

Bailey & Scott's diagnostic microbiology

2017-06-06

Patricia Tille

Blaustein's Pathology of the Female Genital Tract

2019-01-01

Robert J. Kurman , Lora H. Ellenson , Brigitte M. Ronnett

Diverticular Disease of the Colon, a 20th Century Problem

1975-01-01

Neil S. Painter , D. P. Burkitt

Diverticular disease of the colon

2004-02-01

Neil Stollman , Jeffrey B. Raskin

Natural History of Diverticular Disease of the Colon

1975-01-01

T G Parks

[Clinical analysis of 8 cases of laparoscopic combined with colonoscopic transanal total mesorectal resection].

2025-06-25

Sung Yang , C Y , Y Wang +1 more | PubMed

Objective: To explore the feasibility and safety of laparoscopic combined with colonoscopic transanal total mesorectal resection (laparoscopic combined with colonoscopic taTME) in the treatment of rectal cancer. Methods: The descriptive … Objective: To explore the feasibility and safety of laparoscopic combined with colonoscopic transanal total mesorectal resection (laparoscopic combined with colonoscopic taTME) in the treatment of rectal cancer. Methods: The descriptive case series analysis method was adopted. From October 2023 to February 2024, the Department of Colorectal Surgery of Li Huili Hospital, Ningbo Medical Center, performed laparoscopic combined with colonoscopic taTME on 8 patients with rectal cancer. Among the 8 patients, there were 5 males and 3 females, aged from 56 to 74 years old, with a body mass index (BMI) of 20.3-26.7 kg/m². All patients were pathologically diagnosed with rectal adenocarcinoma. The long diameter of the tumors was 2.0-6.5 cm, the lower edge of the tumors was 3-5 cm away from the anal verge. In terms of tumor TNM staging, there were 2 cases in stage I, 3 cases in stage II, and 3 cases in stage III. The surgical conditions, postoperative curative effects, and the occurrence of complications were observed. Results: All 8 patients successfully completed laparoscopic combined with colonscopic taTME, and there was no conversion to laparotomy. The operative time was 260 to 335 minutes, the intraoperative blood loss was 50 to 100 milliliters, and the distance from the tumor to the anal margin was 0.8 to 2.0 centimeters. All patients in the group underwent protective end ileostomy, and none of them underwent permanent enterostomy. Specimens were removed from the right lower abdomen in 7 cases and through the anus in 1 case. There was no residual cancer cells at the pathological resection margins postoperatively. All patients ambulated on the first day after the operation, and began to eat on the 2nd to 3rd day after the operation. Anastomotic leakage occurred in 1 patient after the operation, and the condition improved after conservative treatment. The length of hospital stay was 21 days. The other 7 patients were discharged from the hospital 8 to 12 days after the operation. Two patients completed the ileostomy closure surgery 3 months after the operation and recovered well. The patients were followed up until April 2024, during which there were no cases of tumor recurrence or death. Conclusion: For appropriate cases, laparoscopic combined with colonoscopic taTME is safe and feasible.

The Safety of Primary Anastomosis Without Protective Stoma in Emergency Left Colon Surgery: A Meta-Analysis

2025-06-24

Zhiyan Wang , Wentao Sheng , Senjie Dai +3 more | Journal of Investigative Surgery

This study aims to evaluate the safety of primary anastomosis (PA) without a protective stoma in emergency left colon surgery. A systematic search was conducted in the PubMed, Web of … This study aims to evaluate the safety of primary anastomosis (PA) without a protective stoma in emergency left colon surgery. A systematic search was conducted in the PubMed, Web of Science, Embase, and Cochrane Library databases, covering articles from the inception of these databases until September 2024. The primary outcome was the incidence of anastomotic leakage. The PA group exhibited a higher incidence of anastomotic leakage compared to the stoma surgery group (odds ratios (OR) = 5.86, p = 0.05). However, in cases of perforated diverticulitis (OR = 3.80, p = 0.19) and malignant obstruction (OR = 5.40, p = 0.23), the PA group did not show an increased risk of anastomotic leakage. In terms of other outcomes, the reoperation rate in the PA group was higher compared to the stoma surgery group (OR = 1.89, p < 0.001). However, there were no statistically significant differences in the mortality rate (OR = 1.04, p = 0.80) or the incidence of postoperative complications (OR = 1.50, p = 0.27) between the two groups. Primary anastomosis without a protective stoma is generally safe and can be considered a viable option in emergency left colon surgery.

Nodo-colonic fistula secondary to abdominal TB lymphadenitis

2025-06-23

Mahmoud Arafa | Radiopaedia.org

Predictive Factors of Recurrence in Non-Operative Management of Right-Side Colonic Diverticulitis: Multicenter Retrospective Cohort Study

2025-06-23

| Journal of the Medical Association of Thailand

Background: Non-operative management (NOM) is the primary treatment strategy for uncomplicated right-sided colonic diverticulitis (RCD). However, some patients experience recurrence after successful NOM. Objective: To investigate the recurrence rate and … Background: Non-operative management (NOM) is the primary treatment strategy for uncomplicated right-sided colonic diverticulitis (RCD). However, some patients experience recurrence after successful NOM. Objective: To investigate the recurrence rate and predictive factors for RCD after successful NOM. Materials and Methods: A retrospective review was conducted on medical records of patients diagnosed with uncomplicated RCD at Vajira Hospital and Maharaj Nakorn Chiang Mai Hospital between January 2017 and December 2022. Predictive factors for recurrence were analyzed using multivariable Cox regression, and recurrence-free survival was evaluated using Kaplan-Meier analysis. Results: Ninety patients were diagnosed with uncomplicated RCD, of whom 87 (96.7%) achieved successful NOM. The mean follow-up duration was 56.42 months (SD 18.89). Twelve patients (13.8%) experienced recurrence, with a median recurrence time of 11.5 months (IQR 5.7 to 31.7). There were no significant differences in baseline characteristics between the patients with and without recurrence. Smoking was significantly associated with recurrence (HR 4.56, 95% CI 1.33 to 15.6, p=0.02), with smokers showing lower recurrence-free probabilities at 12, 24, and 60 months compared to non-smokers with 72.7% versus 92.2% at 60 months. Hepatic flexure diverticulitis was also a significant predictor of recurrence (HR 4.59, 95% CI 1.17 to 11.94, p=0.03). Conclusion: In the two-centers study from Thailand, smoking and hepatic flexure involvement were significant predictive factors for recurrence in RCD after successful NOM. These findings highlight the need for close monitoring and tailored management strategies in high-risk patients, and future studies should incorporate larger, multi-center data to validate these results.

Management of Colonic Diverticular Disease in the Older Adult

2025-06-21

Hiep S. Phan , Lisa L. Strate | Current Gastroenterology Reports

Abstract Purpose of Review While societal guidelines help direct management of diverticulitis and diverticular bleeding broadly, our review focuses on the latest data for nuanced care of older patients affected … Abstract Purpose of Review While societal guidelines help direct management of diverticulitis and diverticular bleeding broadly, our review focuses on the latest data for nuanced care of older patients affected by these conditions. Recent Findings Diverticulitis in older patients can present with non-specific symptoms so a broad work up is recommended. Once diagnosed, those with uncomplicated disease (Hinchey Class 0 or 1a) can be safely managed without antibiotics or admission depending on frailty and comorbidities. Most older patients with complicated diverticulitis (abscess, perforation or obstruction) should be hospitalized. Elective or emergent surgery for complicated disease (Hinchey Class 1b–4) is associated with higher morbidity and mortality, particularly in older patients. The risk of diverticular bleeding and re-bleeding significantly increases with age, potentially due to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and anticoagulants. Summary Diverticular disease and its associated complications disproportionately affect older adults. Management should focus on resuscitation, having low threshold for comprehensive work up and re-evaluating medication use for comorbid conditions to prevent recurrence.

Emergency Laparoscopic Right Hemicolectomy With Intracorporeal Anastomosis

2025-06-20

C. McDonald , Zi Qin Ng | Diseases of the Colon & Rectum

Anal Sphincteroplasty for Fecal Incontinence

2025-06-20

Amanda Pereira Lima , Rodrigo Âmbar Pinto , Isaac José Felippe Corrêa Neto | Diseases of the Colon & Rectum

Correction to: Direction of perforation predicts the failure of non-operative management in patients with acute diverticulitis

2025-06-19

Igors Iesalnieks , M Beyer , Ayman Agha +2 more | Langenbeck s Archives of Surgery

Does frailty predict readmission and mortality in diverticulitis? A nationwide analysis

2025-06-19

Omar Hejazi , Christina Colosimo , Muhammad Haris Khurshid +7 more | Journal of Trauma and Acute Care Surgery

INTRODUCTION Diverticulitis is a major health concern in the United States affecting up to 25% of elderly population. It is unknown if frailty increases the risk of recurrent diverticulitis. The … INTRODUCTION Diverticulitis is a major health concern in the United States affecting up to 25% of elderly population. It is unknown if frailty increases the risk of recurrent diverticulitis. The aim of our study is to identify the association between frailty and recurrence of diverticulitis. METHODS We performed a retrospective analysis of the Nationwide Readmissions Database 2019 and included geriatric (65 years or older) patients admitted for acute complicated diverticulitis (ACD) who were managed nonoperatively between January and June and had a 6-month follow-up. Patients were stratified into nonfrail, prefrail, and frail groups using the five-factor modified frailty index. Primary outcome was readmission due to ACD or acute uncomplicated diverticulitis (AUD) at 1 and 6 months after the admission. Secondary outcome was mortality. Multivariable regression analysis was performed to identify the predictors of recurrent diverticulitis and outcomes. RESULTS We identified 10,807 patients (nonfrail, 1,953; prefrail, 4,616; frail, 4,238). No differences were found between the groups in readmissions for recurrent ACD and AUD at 1 month after discharge. However, nonfrail patients and prefrail had higher rates of ACD ( p = 0.009) and AUD ( p < 0.001) at 6 months after index admission. Frail patients had higher mortality on index admission ( p < 0.001) and at 6 months ( p < 0.001). On multivariable regression analyses, frailty was a predictor of mortality on index (adjusted odds ratio, 1.99; p < 0.001) and readmissions (adjusted odds ratio, 3.05; p < 0.001). CONCLUSION Frailty was not identified as a predictor of developing recurrent diverticulitis; however, frail patients are at increased risk of mortality once they develop diverticulitis. Optimal management for frail patients with diverticulitis must be defined to improve outcomes. LEVEL OF EVIDENCE Therapeutic/Care Management; Level III.

Neutrophil-to-lymphocyte ratio: is it more valuable than CRP in assessing severity of acute diverticulitis at initial presentation? A single-center retrospective cohort study

2025-06-18

Nurettin Şahin , Ahmet Sürek , Turgut Dönmez +7 more | Irish Journal of Medical Science (1971 -)

Complicated diverticulitis: medical management or segmental resection?

2025-06-17

Antonio Tursi | Expert Review of Gastroenterology & Hepatology

Diverticulitis is the most common complication related to the diverticulosis of the colon. Since there are some concerns about the management of complicated diverticulitis, the aim of this review was … Diverticulitis is the most common complication related to the diverticulosis of the colon. Since there are some concerns about the management of complicated diverticulitis, the aim of this review was to analyze current medical and surgical approaches to complicated diverticulitis and evolving advances in its management. An analysis of the current PubMed literature about the medical and surgical management of complicated diverticulitis was performed. Attentive evaluation of the characteristics of complicated diverticulitis may make the difference when approaching its management: detection of large abscesses, or perforation with significant free air in the abdomen remain typical predictors of failed medical management, therefore often requiring surgery. However, recent data support the medical approach as first choice in managing small abscesses or small perforation with small bubble of free air in the abdomen. Further studies have to point out better the evolution of the medical approach also in patients with complicated diverticulitis.

A rare disease presenting with acute abdominal pain in a girl: Solitary cecal diverticulum

2025-06-17

Hanife Özcan , Mehmet Özer , Mete Kaya | The European Research Journal

Solitary cecal diverticulum (SCD) is a rare gastrointestinal disease, especially in children, predominantly observed in middle-aged Asian men, and presented with nonspecific symptoms similar to acute appendicitis. Herein we report … Solitary cecal diverticulum (SCD) is a rare gastrointestinal disease, especially in children, predominantly observed in middle-aged Asian men, and presented with nonspecific symptoms similar to acute appendicitis. Herein we report a case of SCD in a 15-year-old girl who had acute abdominal pain symptoms, and was diagnosed intraoperatively. The SCD, which contained a fecalith, was excised, followed by cecal repair and an appendectomy. Histopathological examination confirmed the diagnosis of SCD. This case highlights the importance of considering SCD in the differential diagnosis of acute abdominal pain, particularly in pediatric patients.

Lupus Mesenteric Lymphadenitis

2025-06-16

Yuki Ohnishi , Kentaro Trerattanavong , Yayoi Hayakawa +1 more | Arthritis & Rheumatology

Comment on “Effect of Using Automated Irrigation Systems on the Risk of Infectious Complications after Endoscopic Combined Intrarenal Surgery: A Retrospective Cohort Study”

2025-06-16

Emma Waddell , Daniel Wollin | Journal of Endourology

Frailty is a prognostic marker of mortality and sepsis in patients ≥ 70 years with acute left-sided colonic diverticulitis

2025-06-16

Vito Laterza , Marcello Covino , Carlo Alberto Schena +7 more | International Journal of Colorectal Disease

Acute left-sided colonic diverticulitis (ALCD) has a more complicated course in older patients. Rather than age, frailty may be crucial in ALCD prognosis in this heterogeneous population. This study aims … Acute left-sided colonic diverticulitis (ALCD) has a more complicated course in older patients. Rather than age, frailty may be crucial in ALCD prognosis in this heterogeneous population. This study aims to define the influence of the Clinical Frailty Scale (CFS) on mortality and clinical outcomes in patients aged 70 or older with ALCD. All patients aged ≥ 70 years admitted to the emergency department for ALCD between January 2018 and December 2022 were included. Frailty was assessed through the CFS, and three groups of patients were identified accordingly: non-frail patients (CFS 1-3); moderately frail patients (CFS 4-6); and severely frail patients (CFS 7-9). The endpoints were: 30-day mortality, sepsis onset, 30-day readmission, and length of hospital stay (LOS). A total of 1127 patients were enrolled. Severely frail patients had a significantly higher rate of sepsis onset, mortality, and longer LOS at univariate analysis. Higher CFS scores were significantly associated with mortality, both as a continuous (OR 1.42) and discrete variable (OR 12.47), and sepsis, both as a continuous (OR 1.5) and discrete variable (OR 6.52) at multivariate analysis. A higher CFS score, rather than age, is associated with higher rates of mortality, sepsis, and longer LOS. After adjusting for covariates, higher CFS scores were significantly associated with increased risk of 30-day mortality and sepsis. A comprehensive frailty assessment using the CFS should be considered to predict the need for closer monitoring and guiding appropriate care goals for older patients.

The use of patient-reported outcome measures in recurrent diverticulitis

2025-06-16

Megan Shroder , Thomas E. Ueland , Liping Du +5 more | Surgery

National guidelines for elective colectomy for uncomplicated diverticulitis have changed to a patient-centered approach. Patient-reported outcome measures, such as the Diverticulitis Quality of Life Instrument, may be helpful to determine … National guidelines for elective colectomy for uncomplicated diverticulitis have changed to a patient-centered approach. Patient-reported outcome measures, such as the Diverticulitis Quality of Life Instrument, may be helpful to determine who will benefit from elective colectomy for diverticulitis. We performed a prospective observational cohort study to investigate whether greater Diverticulitis Quality of Life Instrument scores (indicating more severe disease burden) would be associated with increased likelihood of electing to undergo colectomy for recurrent diverticulitis. Adult patients ≥18 year old seen in consultation for uncomplicated diverticulitis at a tertiary referral medical center from March 2021 to August 2023 were included for analysis. The primary outcome of interest was the decision to proceed with elective colectomy vs. continued medical management. Of the 70 patients included, 48 (68.6%) elected for medical management and 22 (31.4%) had elective surgery planned or completed during the study period. The mean overall Diverticulitis Quality of Life Instrument scores were 4.6 (standard deviation, 1.8) for the medical management group and 5.3 (standard deviation, 1.2) for the elective colectomy group. An adjusted multivariable analysis showed an odds ratio of 1.39 (confidence interval, 1.03-1.89, P = .04) for electing surgical management with one-unit greater baseline Diverticulitis Quality of Life Instrument overall score and an odds ratio of 1.36 (confidence interval, 1.03-1.78, P = .03) for one-unit greater baseline Diverticulitis Quality of Life Instrument score in the subdomain of behavior. We observed significantly greater baseline overall Diverticulitis Quality of Life Instrument scores and scores in the subdomain of behavior in patients who chose to pursue elective colectomy after consultation for recurrent diverticulitis.

Emergency laparoscopic Hartmann procedure no longer a subspecialist operation: a retrospective cohort study at an Australian non-subspecialized center

2025-06-15

Daniel E. Cattanach , Peter Tilleard , Jana Bednarz +1 more | Daehan nae'si'gyeong bog'gang'gyeong oe'gwa haghoeji/Journal of minimally invasive surgery

An open Hartmann (OH) procedure generally remains the standard of care for several emergent colorectal conditions. There is a perception that the laparoscopic approach is limited to large subspecialist centers. … An open Hartmann (OH) procedure generally remains the standard of care for several emergent colorectal conditions. There is a perception that the laparoscopic approach is limited to large subspecialist centers. This study aimed to investigate the outcomes of these emergency procedures in a non-subspecialized regional center. We conducted a retrospective cohort analysis on patients who underwent an emergency Hartmann procedure between 2019 and 2023 within a general surgery unit at a regionally located tertiary-level Australian hospital. Patients were classified as having undergone either OH or laparoscopic Hartmann (LH) procedures. Our primary outcome of interest was length of hospital stay (LOS). Secondary outcomes included time to return of gut function, morbidity, and reversal. Differences between the OH and LH groups were assessed descriptively and using confounder-adjusted regression. We identified 115 patients (83 underwent OH, 32 underwent LH) during the study period. The adjusted estimated mean LOS for patients undergoing an OH procedure was 15.8 days (95% confidence interval [CI], 13.7-17.9) compared to 9.6 days (95% CI, 7.4-11.9) for patients undergoing an LH procedure. The mean time taken for the return of gut function was estimated to be 34% longer following an OH procedure compared to an LH procedure (adjusted incidence rate ratio, 1.34 days; 95% CI, 1.00-1.81). Morbidity was similar between groups. The LH group had higher rates of laparoscopic reversal (91.7% vs. 33.3%). The expected benefits of laparoscopic surgery may extend to the emergency colorectal setting and LH procedures can be performed safely in a non-subspecialized center.

Can computed tomography extra-luminal mesenteric signs differentiate accurately between sigmoid diverticulitis and sigmoid cancer?

2025-06-15

Mohsen Ahmed Abdelmohsen , Ahmed Refaat , Yasser H. Zaki +2 more | The Egyptian Journal of Radiology and Nuclear Medicine

Abstract Background The primary challenge in diagnosing diverticulitis is ruling out colon cancer, as both conditions are common in the elderly population and have similar clinical and imaging appearances. The … Abstract Background The primary challenge in diagnosing diverticulitis is ruling out colon cancer, as both conditions are common in the elderly population and have similar clinical and imaging appearances. The aim of this work was to analyze the usefulness of specific diagnostic CT mesenteric signs for identifying and differentiating sigmoid diverticulitis from sigmoid cancer by contrast-enhanced computed tomography and correlation with histopathological data. Results There were significant differences between both groups regarding fat stranding proportionate or disproportionate, comma sign, and engorged mesenteric vessels ( P < 0.05). Conclusions Differentiating between sigmoid diverticulitis and cancer is crucial, especially in the elderly, due to their similar clinical presentations and imaging characteristics. A careful evaluation of CT mesenteric findings alongside clinical symptoms and potential endoscopic results is essential to accurately distinguish between these conditions.

Kid Lit Not Split by a Colon

2025-06-15

Anna Krushelnitskaya | University Press of Mississippi eBooks

A Retrospective Study on Use of Neutrophil‐Lymphocyte Ratio as a Prognostic Measurement to Assess Acute Diverticulitis

2025-06-13

Yam-Ting Ho , Omattage Mahasha Perera , Femi E. Ayeni +7 more | ANZ Journal of Surgery

ABSTRACT Background Acute diverticulitis (AD) is a common surgical condition and the Neutrophil‐lymphocyte ratio (NLR) is an emerging biomarker ratio used to guide its management. The aim of this study … ABSTRACT Background Acute diverticulitis (AD) is a common surgical condition and the Neutrophil‐lymphocyte ratio (NLR) is an emerging biomarker ratio used to guide its management. The aim of this study is to validate and assess the utility of the NLR in AD in the Australian population. Methods This is a single centre retrospective observational study of patients who presented to the emergency department with the diagnosis of AD between September 2018 and September 2023, in Ipswich, Queensland. One thousand five hundred and forty patients were screened against exclusion/inclusion criteria and 634 patients were available for analysis. Results The study identified NLR, CRP (C‐reactive protein) and age to be significant coefficients in predicting length of stay (LOS) in regression analysis. NLR (OR1.06, p < 0.001) and CRP (OR1.01, p < 0.001) were significant predictors for surgical management of diverticulitis. NLR was found to be superior predictor of surgical management in ROC analysis (AUC 0.75, sensitivity 65%, specificity 75%, p < 0.001) compared to CRP, but both were equivalent in predicting for diverticulitis severity and percutaneous drainage. Further analysis revealed NLR between those receiving surgery, percutaneous drainage and readmission (One‐way ANOVA) and NLR between modified Hinchey classifications were also significantly different (Mann–Whitney U). Conclusion In this study, we have further validated the effectiveness of NLR as a diagnostic marker. In particular, NLR is superior to CRP in predicting surgical management. It has also proven useful to predict for LOS, disease severity and percutaneous drainage. NLR usage should be encouraged in the clinical setting as it is simple and effective.

Influence of Neighborhood-Level Social Risk Factors on Quality of Care and Outcomes for Diverticulitis Patients

2025-06-01

Jessica Liu , Yaoming Liu , Mark E. Cohen +3 more | Journal of Gastrointestinal Surgery

Parameters of Body Composition Predict Clinical Course in Acute Colonic Diverticulitis

2025-06-01

Alexey Surov , Mattes Hinnerichs , Iram Shahzadi +5 more | Journal of Cachexia Sarcopenia and Muscle

Colonoscopic Findings of Patients with Rectal Bleeding: Insights from a Single Centre Study

2025-06-01

Mohamed Elbadry , Mina Tharwat , Noha Eltaweel +2 more | Journal of Coloproctology

Abstract Rectal bleeding is a common symptom prompting an urgent investigation. Colonoscopy plays a crucial role in diagnosing the underlying cause and guiding treatment. We aimed to analyze colonoscopic findings … Abstract Rectal bleeding is a common symptom prompting an urgent investigation. Colonoscopy plays a crucial role in diagnosing the underlying cause and guiding treatment. We aimed to analyze colonoscopic findings in patients with rectal bleeding at a single center. A retrospective review was conducted on the medical records of patients who underwent colonoscopy for suspected rectal bleeding. Data collected included demographics, clinical presentation, colonoscopic findings, and final diagnoses. A total of 205 patients underwent colonoscopy for rectal bleeding. The mean age was 47.35 ± 14.6 years, with a male predominance of 57.5%. Hematochezia was the most common presentation (73%), followed by melena (18%) and maroon stools (9%). Colonoscopy identified 5 different sources of bleeding. Hemorrhoids were the most common endoscopic finding (76%), followed by combined hemorrhoids and colonic polyps (38%), colonic polyps alone (28%), and colorectal cancer (20%). No lesions were detected in 10% of patients. The left colon emerged as the most frequent site for bleeding lesions (88.1%). Age influenced the distribution of endoscopic findings. Hemorrhoids were prevalent in both age groups, but the presence of both hemorrhoids and polyps/masses was more frequent in younger patients (<45 years). Rectal ulcers were observed exclusively in younger patients, while CRC showed a slightly higher prevalence in this group. Hemorrhoids are the leading cause of LGIB in Upper Egypt, with a higher prevalence compared to other regions. The left colon was the common location for bleeding lesions. Age may influence the causes of LGIB, younger patients present more frequently with combined pathologies.

Fascial platform technique in transumbilical single-incision laparoscopic repair of peptic ulcer perforations: An innovative access strategy

2025-06-01

Dan Dan Li , G. Xiao | Asian Journal of Surgery

Reversal of Hartmann’s Procedure: The Impact of Timing – A Single-Tertiary-Center Experience

2025-06-01

Sascha Vaghiri , Maria Chara Stylianidi , Laura Engelmann +5 more | Surgery in Practice and Science

The outcomes of right and left complicated colonic diverticulitis

2025-06-01

Anh Tuan Nguyen , Q T Pham , Huy Tran +2 more | Surgery Open Science

Identification of core gene-gut microbiome associations in diverticulitis patients through a two-sample mendelian randomization and bioinformatics-based investigation

2025-06-01

Wende Hao , Zhenjun Wang , Huachong Ma | Global Medical Genetics

SIMULTANEOUS LAPAROSCOPIC SPLENECTOMY AND CHOLECYSTECTOMY (a case study with a brief literature review)

2025-06-01

E. V. Mahiliavets , A. A. Moroz | Hepatology and Gastroenterology

Background. Simultaneous operations are a combination of several types of interventions during one laparoscopic procedure, with a good cosmetic result and rapid recovery after surgical aggression. Objective. Analysis of our … Background. Simultaneous operations are a combination of several types of interventions during one laparoscopic procedure, with a good cosmetic result and rapid recovery after surgical aggression. Objective. Analysis of our own and available published outcomes of performing simultaneous laparoscopic splenectomy and cholecystectomy. Material and methods. The article presents a detailed description of our own experience of simultaneous laparoscopic splenectomy and cholecystectomy for a large posttraumatic splenic cyst and cholelithiasis. It also analyzes the available literature on the advantages and benefits of combined laparoscopic interventions. Results. The use of laparoscopic technologies allowed us to successfully perform simultaneous removal of the spleen and gallbladder during one surgical intervention. The postoperative period was uneventful. The patient was discharged for outpatient treatment. In the late postoperative period, she feels satisfactory. The data available in the scientific press confirm the effectiveness and safety of performing simultaneous combined laparoscopic interventions in patients with pathological changes in the spleen and gallbladder. Conclusion. The described clinical case alongside with the analyzed publications indicate that simultaneous operations for combined abdominal pathology are a feasible treatment option.

Robotic right hemicolectomy for persistent colocutaneous fistula following laparoscopic appendectomy: A case report

2025-06-01

Kalamutova Ana , Jurij Aleš Košir , Jurij Janež +1 more | SAGE Open Medical Case Reports

The article presents a case report of a patient who was referred to our hospital after laparoscopic appendectomy with several revisions, resulting in a persistent colocutaneous fistula to the hepatic … The article presents a case report of a patient who was referred to our hospital after laparoscopic appendectomy with several revisions, resulting in a persistent colocutaneous fistula to the hepatic flexure. After preoperative planning, a robotic right hemicolectomy was performed. The patient was discharged on postoperative day 7 with no postoperative complications. We concluded that robot-assisted colectomy after preoperative patient management can be performed as an effective technique for colocutaneous fistula treatment with the benefits of minimal invasive surgery, including reduced postoperative pain, early patient mobilization, and shorter hospital stay.

Endoscopic balloon dilation with injection of platelet-rich plasma in management of recurrent stenosis in a patient with Crohn’s disease (with video)

2025-06-01

Yi Lu , Jun Yang , Jing Li +1 more | Gastrointestinal Endoscopy

Unilateral Epididymo-Orchitis With Complicated Urinary Tract Infection: A Clue to Underlying Vesicoureteral Reflux

2025-05-31

Rajarajan Paulpandian , Upasana Ranga | Cureus