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PubMed · 8371620

Diverticulitis.

S R Freeman·P R McNally
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Abstract

Diverticulitis is an important complication of diverticulosis that affects only 10% to 20% of patients with this condition. Medical and surgical aspects of management of diverticulitis are discussed in this article. Some unusual and less well-known complications and manifestations of this common clinical problem are also described. This disease remains a challenging problem that demands sound clinical judgement by the internist and the surgeon.

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ColectomyColonColonoscopyColostomyCombined Modality TherapyDiagnosis, DifferentialDiverticulitis, ColonicHumansRadiographyUltrasonographyJournal ArticleReview

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S R Freeman, P R McNally. 1993. Diverticulitis.. https://doi.org/10.1016/s0025-7125(16)30215-2

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A male newborn with colonic atresia and total colonic aganglionosis.

A case of colonic atresia (CA) and aganglionosis is presented, which is probably the tenth in the English literature. The boy presented on day 3 of life with delayed passage of meconium, milk intolerance, and progressive abdominal distension. A barium enema study was complicated by barium peritonitis. Emergency peritoneal lavage was done and the intestinal obstruction was relieved by a proximal defunctioning ileostomy; type III CA (Grosfeld classification) was identified. The proximal atretic end was the blind-ending caecum and the distal atretic end commenced in the splenic area as a microcolon extending to the pelvis and replacing the normal colon. Total colonic aganglionosis (TCA) was confirmed by biopsies. This is the first case in the literature of TCA with CA documented before any attempts at colonic resection and anastomosis were made. This association highlights the recommendation for biopsy of the micro-colon and rectum when Type III CA (Grosfeld classification) is encountered in a newborn. The infant underwent a cholecystectomy and Duhamel-Martin operation at 14 months that was complicated by abdominal wound dehiscence; the ileostomy was closed at 22 months of age.

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