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At least 289 records · Page 16Linked to original sources
PubMed1999

[Zenker's diverticulum].

An experience with treatment of 14 women and 15 men aged from 41 to 83 years with Zenker's diverticulum was analyzed. Most liable to the disease were people at the age from 50 to 70 years. The average duration of the disease was 3-4 years. All the patients were subjected to improved surgical interventions: resection of the diverticulum (11 patients), operations under the control of the endoscopic technique (18 patients). Resections of the diverticulum were combined with cryopharyngeal myotomy. No complications were noted. There were no lethal outcomes. So, wider indications to operative treatment in patients with Zenker's diverticulum, endoscopic methods used at all stages of treatment as well as improved methods of performing the operation enabled the authors to obtain good immediate and long-term results.

Adult↗
PubMedDate not supplied

[2 cases of choledochal calculosis associated with juxtapapillary diverticulum in patients with gastric resection: submesocolon approach].

Although laparoscopy and endoscopy have reduced the need for laparotomies in biliary tract surgery, open surgery is sometimes still needed. One case in particular is when previous operations have significantly distorted normal upper abdomen anatomy. We chose an inframesocolic entrance to the posterior peritoneum in two patients with bile duct stones, juxtapapillary duodenal diverticulum and a history of cholecystectomy and partial gastric resectioning. The duodenum was reached at the junction between the second and third section by entering the posterior peritoneum through the inferior sheet of the mesocolon, a relatively avascular area. The diverticulum was incised, the sphincter and papilla operation was performed and the bile duct stones removed. The diverticulum was then resected. Our conclusion is that in certain cases, an inframesocolic entrance can significantly reduce technical difficulties involved in re-operating through dense adhesions, minimize surgical time and blood loss and, when operating through the open diverticulum, spare an unnecessary duodenotomy.

Cholecystectomy↗
PubMed1999

Prenatal diagnosis of a fetal left atrial diverticulum.

Fetal echocardiography, performed on a 22-year-old woman at 31 weeks' gestation, revealed a diverticulum of the left atrium. The size of the diverticulum was similar to the size of the fetal heart in a four-chamber view. No evidence of congestive heart failure or changes in size of the diverticulum were observed on subsequent ultrasound examinations. The echocardiographic image suggested presence of a thrombus within the diverticulum. Echocardiography of the newborn confirmed the diagnosis, and surgical correction followed five days after the birth. Our approach to this problem is discussed here.

Adult↗
PubMed1976

[Clinical importance of Meckel's diverticulum].

Between 1966 und 1975 42 children and 46 adults were operated on Meckel's diverticulum. The diverticulum is explained as one of the possible disturbances during regression of ductus omphaloentericus. The appendicitis-like symptomatology correlates to the involvement of gastric and colonic mucosa as well as heterotopic exo- and endocrine tissue of the pancreas in the wall of the diverticulum. In 34% complications were due to inflammation, perforation, bleeding, intussusception, volvulus, gut-strangulation with ileus, ulcer, neoplasia or lesion by foreign bodies. 4 out of 88 patients died. Preoperative diagnostic fails in 75%, therefore in every case the distal gut should be inspected and every diverticulum should be resected.

Adult↗
PubMed2000

Urethral diverticulum in women: diverse presentations resulting in diagnostic delay and mismanagement.

PURPOSE: We describe various clinical presentations of urethral diverticulum, which may mimic other pelvic floor disorders and result in diagnostic delay. Management and outcome results are reported. MATERIALS AND METHODS: We reviewed retrospectively 46 consecutive cases of urethral diverticulum. Patient characteristics, history, clinical evaluation, management and long-term followup are reported. RESULTS: Mean patient age plus or minus standard deviation was 36.3 +/- 11.7 years. Most (83%) cases were referred as diagnostic dilemmas with symptoms present for 3 months to 27 years. Mean interval between onset of symptoms to diagnosis was 5.2 years. The most common symptoms were pain (48% of cases), urinary incontinence (35%), dyspareunia (24%) and frequency/urgency (22%). The number of physicians previously consulted ranged from 3 to 20 and prior therapies included oral and/or vaginal medications, anti-incontinence surgery and psychotherapy. The diverticulum was palpable on examination in 24 patients (52%), in only 6 of whom was it possible to "milk" contents per meatus. Of these 24 palpable diverticula 2 contained malignancy, and 2 others contained endometriosis and stones, respectively. Diagnosis was made by voiding cystourethrography in 30 cases (65%), double balloon urethrography in 5 (11%) and transvaginal ultrasound or magnetic resonance imaging in 7 (15%). Diverticula were incidental findings during vaginal surgery in 4 cases (9%). Treatment consisted of diverticulectomy and/or Martius flap, pubovaginal sling and urethral reconstructive procedures when indicated in 35 cases (76%), and 2 other patients underwent radical surgery for diverticular malignancy. Subsequently all but 2 patients with pain were cured. In another patient de novo stress incontinence developed postoperatively. None of the patients who underwent concomitant pubovaginal sling had postoperative incontinence. CONCLUSIONS: The symptoms of urethral diverticulum may mimic other disorders. This condition should be considered in women with pelvic pain, urinary incontinence and irritative voiding symptoms not responding to therapy. Surgical treatment is usually effective in alleviating associated symptoms.

Adolescent↗
PubMed2000

Zenker's diverticulum treated by the endoscopic stapling technique.

The objective of the present study is to determine whether the endoscopic stapling technique for the treatment of Zenker's diverticulum provides a relief of symptoms and an acceptably low number of complications. Previous studies have indicated that endoscopic stapling of the common wall between the oesophagus and the diverticulum is a safe and effective method that has a low complication rate and only necessitates a few days of hospitalization. To the present only a few investigations including a limited number of patients have reported the clinical outcome with regard to relief of symptoms and degree of satisfaction in a group of patients treated with this new approach. Twenty-three consecutive patients with Zenker's diverticulum treated with endoscopic staple-assisted oesophagodiverticulotomy were investigated. The median age was 70 years and the median observation time was 12 months. All patients but one (96%), reported significant relief of symptoms and 76% had no symptoms at all at the time of follow-up. In one patient, a postoperative episode of uncomplicated fever occurred, which was managed successfully with gastric tube and antibiotics. Most patients resumed oral intake of fluids and foods within the first postoperative day. The high degree of patient satisfaction, the low rate of complications and the few recurrences of symptoms reported in the present study indicate that the endoscopic stapling technique is an efficient and reliable treatment for Zenker's diverticulum.

Aged↗
PubMed2000

[Meckel's diverticulum. Our experience].

BACKGROUND: The paper aimed to highlight the percentage presence of Meckel's diverticulum compared to appendiceal pathology in a retrospective study and whether its surgical removal is always useful, even if asymptomatic. METHODS: The study was performed at the Institute of Emergency Surgery at the Second University of Naples (Head: Prof. R. Docimo) in 1211 patients affected by appendiceal-like pathology, reported to the authors' attention for both elective and emergency surgery from 1973 to today. The presence of Meckel's diverticulum was rarely diagnosed in preoperative patients; it was occasionally found in both elective surgery in patients with other abdominal pathologies, above all appendicitis, and in patients undergoing emergency surgery for acute pathologies (occlusion, peritonitis) caused by the former. The diverticulum was always totally removed (diverticulectomy or intestinal resection) even when it was asymptomatic. RESULTS: The results were satisfactory in all patients and at the one-year follow-up none complained of discomfort. CONCLUSIONS: We are convinced that Meckel's diverticulum should be investigated as a matter of course during appendectomy and, where present, it should be removed even if asymptomatic because the problems arising secondary to complications are undoubtedly more severe compared to any discomfort following its surgical removal.

Adolescent↗
PubMed2000

Urethral diverticulum in females: 25 years experience at Ramathibodi Hospital.

We retrospectively reviewed the urethral diverticulum in females from 1972 to 1997. Sixty seven patients were found in this study. Nine per cent were nulliparous and the rest were multiparous with the mean of 2.2 births (range 1-6). Voiding cystourethrography and intravenous pyelography were the main diagnostic investigations (92.4%). Stones in the diverticulum were found in 4.4 per cent. The treatment included marsupialization for the diverticulum at distal urethra in 14 per cent and diverticulectomy for the diverticulum at middle and proximal urethra in 86 per cent. The complications included 1.4 per cent of stress incontinence and 4.4 per cent of recurrent infection.

Adult↗
PubMed1998

[Sudden sensorineural hearing loss and jugular bulb diverticulum].

The relationship between high placed jugular bulb (diverticulum) and inner ear disorder is not well known. Three of 19 patients with sudden sensorineural hearing loss (SSHL) treated in 1995 had right side jugular bulb diverticulum revealed by CT scan and MRA. One of the 3 SSHL cases complicated with delayed endolymphatic hydrops. The exact mechanism of causation of inner ear symptom is not clear, but may partly be due to pressure effects with the jugular fossa encroaching on inner ear structure such as the cochlear aqueduct and vestibular aqueduct, and due to turbular flow in the diverticulum striking the inner ear. It is needed to further study the influence of the diverticulum on the inner ear.

Adult↗
PubMed1979

[Tractional diverticulum of the urinary bladder as a component in recurring inguinal hernias].

The tractonal diverticulum as contained in recidivating inguional hernia occur rather often. They are created most often during plastic surgical treatment most frequently in inguinal hernia repairs in which a suture partially or completely passes through the urinary bladder and fixes it to the layers of inguinal canal when it is being sutured. They also occur when the bladder is accidentally pinched while the sutures are being pulled taught. The diverticulum so created almost never yields characteristic symptoms, and for this reason it is most often diagnosed intraoperatively. Because of this, the surgeon must keep in mind the possible existence of such a diverticulum when reoperating a recidivating hernia localized in the lower abdomen especially those near the bladder. It is important that such a diverticulum be carefully dissected and that the bladder be adequately closed with a layers of catgut sutures. An accidental -- overlooked lesion of the urinary bladder during operation can have a fatal outcome. For this reason such lesions must never be overlooked, and should be resolved during the hernioplasty itself.

Diverticulum↗
PubMedDate not supplied

[Intestinal obstruction by Meckel's diverticulum: a case study].

The intestinal obstruction by Meckel s diverticulum is caused by an adherence, volvulus or invagination affecting this diverticulum. This is not a very frequent event and our purpose is to describe a case of intestinal obstruction by a bridle formed by Meckel s diverticulum. Clinically, the patient experienced pain in the periumbilical region, abdominal distension and bilious vomits. The exploratory laparotomy evidenced the existence of Meckel s diverticulum without signs of inflammation.

Child↗
PubMedDate not supplied

Carcinoid tumor in a Meckel's diverticulum: hypothesis on mutual embryological origin.

Congenital defects presenting at an adult age are subject to diagnostic errors because of their relative rarity and often odd clinical presentation. We illustrate a 63-year-old male patient with multiple ileal carcinoid tumors along with a carcinoid tumor in Meckel's diverticulum. The Meckel's diverticulum is a congenital abnormality arising from a patent vitelline duct and is found at the anti-mesenteric side of the ileum. In the Meckel's diverticulum, ectopic tissue or neoplasms are sometimes found, which may lead to intussusception, hemorrhage, or inflammation. The carcinoid tumor is a neuroendocrine neoplasm originating from the neural crest and is diagnosed at virtually all ages. It may exhibit malignant behavior but generally has a mild clinical course. It is most often found in endodermally derived organs, especially the digestive and pulmonary tracts, and coexists frequently with malignant tumors, predominantly of endodermal origin such as colorectal carcinoma. The carcinoid tumor and Meckel's diverticulum are known to coincide, whereas the carcinoid is not really considered to be an embryologically determined defect. We hypothesize that both lesions are derived from local erroneous interaction among the neural crest and the endoderm.

Carcinoid Tumor↗
PubMedDate not supplied

Laparoscopy diagnosis and treatment excision of bleeding Meckel's diverticulum in a child: report of one case.

Meckel's diverticulum is a common cause of low gastrointestinal bleeding in childhood. Conventional diagnostic methods including plain abdominal radiographs, abdominal ultrasound, technectium 99m pertechnetate scintigraphy, angiography, and exploratory laparotomy have several limitations. Here, we report that a case of Meckel's diverticulum in a 1-year-7-month-old boy presenting with intermittent episodes of painless low gastrointestinal bleeding for about one year. Despite the traditional studies, including plain abdominal films, abdominal ultrasound, rectosigmoidoscopy and repeated Tc-99m Meckel's scan, all showed negative finding, it was successfully diagnosed along with excision of Meckel's diverticulum by laparoscopy. The patient made a rapid recovery and discharged at 48 hours after the procedure. We emphasize that laparoscopy should be an alternative diagnostic and therapeutic modality of choice in patients suspected of Meckel's diverticulum, especially in pediatric patients who had negative results of all other work-ups.

Gastrointestinal Hemorrhage↗
PubMed1992

[A case of congenital esophago-bronchial fistula communicated between esophageal diverticulum and left main bronchus in the adult--a review of 47 cases in the Japanese literature].

We experienced a successful repair of congenital esophago-bronchial fistula communicated between esophageal diverticulum and left main bronchus in adult case. The patient was a 60-year-old female. She had much wet cough on taking meals since 10 years ago. At the mass screening, a esophago-bronchial fistula was detected by upper GI series. Barium esophagography revealed a fistula between esophageal diverticulum and left main bronchus. The resection of diverticulum and fistula were undergone. In the operation, there exited no adhesion or inflammation around the fistula, therefore it was easy to isorate from the surrounding tissues. This case was categorized as Brainbridge type I esophago-bronchial fistula communicated to left main bronchus. Forty-six cases of congenital esophago-bronchial fistula with diverticulum were reported in Japan, but no cases which communicated with left main bronchus were reported. Then it is assumed that this is the first case in Japan.

Bronchial Fistula↗
PubMed2004

[Anesthesia for carbon dioxide laser surgery to correct Zenker's diverticulum].

Two 48- and 62-year-old men, the latter with a history of ischemic heart disease, underwent endoscopic carbon dioxide laser surgery to correct Zenker's diverticulum. We provided total intravenous anesthesia, taking into consideration the special requirements of laser surgery. The pathogenesis of Zenker's diverticulum, the most common type of esophageal diverticulum, is poorly understood and the treatment approach depends on size and overall patient status. Patients with Zenker's diverticulum need a thorough preoperative assessment with special attention to airway permeability and the degree of difficulty of intubation. Anesthesia should be maintained in a manner that provides the safest, most effective surgical conditions.

Anesthesia↗
PubMed2004

[Endoscopic stapling diverticulostomy for Zenker diverticulum].

INTRODUCTION: The authors have successfully applied the endoscopic stapling diverticulostomy for three patients with symptomatic Zenker diverticulum. METHOD: Under light general anesthesia the hypopharynx was explored with a rigid, double lipped laryngoscope (Weerda, Storz). The common wall between the esophagus and and diverticulum was cut across and reunited with a endosurgical stapler. RESULTS: Operating time was 25 minutes in average. There were no intraoperative or postoperative complications. The oral feeding was started on the 2. postoperative day. The patients were symptom-free and they were discharged on the fifth postoperative day. The preoperative symptoms were not reported at follow-up assessment. CONCLUSION: The endoscopic stapler diverticulostomy offers distinct advantages, including brief operative time, short hospitalization, reduced morbidity, early oral feeding and predictable resolution of symptoms. The authors proposed the technique in the treatment of the patients with Zenker's diverticulum especially for elderly cases with diverticulum larger than 3 cm.

Aged↗
PubMedDate not supplied

Perforation of Meckel's diverticulum by roundworm.

An 11-month-old girl child presented with distension of abdomen, constipation, vomiting and fever. X-ray of the abdomen suggested intestinal obstruction. Exploration revealed the distal ileum to be kinked around a band running from the tip of a congested Meckel's diverticulum to the lateral pelvic wall. A small perforation was noticed at the tip of the diverticulum and a live roundworm was found lying free in the peritoneal cavity. The diverticulum along with a segment of adjoining bowel was resected and end-to-end anastomosis done. The diverticulum had a wide lumen and showed no heterotopic tissue on subsequent examination.

Abdominal Pain↗
PubMed1992

Adenocarcinoma in Meckel's diverticulum: report of a case and review of 30 cases in the English and Japanese literature.

A 54-yr-old man who complained of abdominal pain was found to have an adenocarcinoma arising in Meckel's diverticulum, as preoperatively diagnosed with 99mTc-pertechnetate scintigraphy. Angiography of the superior mesenteric artery revealed multiple branched arteries and tumor stain, but the vitelline artery was not clearly identified. Surgery revealed that the tumor had invaded the urinary bladder and the ileum, including the diverticulum, and the bladder had to be partially resected. Histopathological examination of the lesion revealed a diverticulum containing normal small bowel mucosa, ectopic normal gastric tissue, and adenocarcinoma. In a review of 30 cases of adenocarcinoma in Meckel's diverticulum in the English and Japanese literature, our case was the first to be diagnosed preoperatively.

Adenocarcinoma↗