Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Diverticulum”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMed1975

[The congenital urethral diverticulum of the Male Urethra of adults].

On 4 male adults we demonstrated a congenital urethral diverticulum. The clinical symptomatology mainly showed the inflammatory micturition difficulties, while the obstructive micturtition symptomatology of the childhood was hardly registered by the patients. Injection and micturition urethrogram led to the diagnosis. The mostly additional obstructive effect of a diverticulum can be well diagnosed by urodynamic investigations (cystourethromanometry and uroflowmetry). We used the following treatment: removal of the membrane between diverticulum and urethra and resection of the urethral diverticulum with primary urethral obstruction. The advantages of an open approach in comparison to endoscopical therapy were pointed out.

Adult↗
PubMed1994

[A case report of giant esophageal leiomyoma associated with an epiphrenic esophageal diverticulum].

A well-nourished 33-year-old male, who was entirely asymptomatic and in apparently good health, was referred to our hospital because of abnormal findings on a routine chest X-ray film. A chest X-ray taken upon admission revealed an oval mass suggesting a mediastinal tumor in the posterior mediastinum. An esophagogram demonstrated severe distortion of the esophageal lumen and an epiphrenic diverticulum on the right side. Endoscopy disclosed a submucosal bulge covered by normal mucosa. The mass, which was located on the right diaphragm between the heart and right ribs, appeared to be of homogenous density on CT scan and MRI films. Infiltration of contiguous structures and enlargement of mediastinal lymph nodes appeared to be absent. The preoperative diagnosis was an esophageal leiomyoma. A right posterior thoracotomy was performed in the prone position under general anesthesia. The tumor (12 x 8 x 4.5 cm, 170 g) associated with an epiphrenic esophageal diverticulum was removed by a partial esophageal resection. The pathologic specimen showed a leiomyoma with normal esophageal mucosa and a true diverticulum containing all the layers of the esophageal wall. We suggest that the diverticulum resulted from retraction of the esophageal wall related to the extraluminal growth of the leiomyoma.

Adult↗
PubMed1994

Biliary diverticulum with pancreaticobiliary maljunction.

The case of a 48-year-old Japanese man with a biliary diverticulum (type B by the so-called Alonso-Lej classification) accompanied by pancreaticobiliary maljunction is reported on herein. The patient had epigastric distress, and an ultrasound examination suggested gallstones and adenomyomatosis of the gallbladder. Subsequent endoscopic retrograde cholangiopancreaticography demonstrated a 3 mm biliary diverticulum in the intrahepatic bile duct and pancreaticobiliary maljunction. Intra-operative cholangiography confirmed both the diverticulum and the pancreatiocobiliary maljunction. Cholecystectomy alone was performed. The histological diagnosis of the gallbladder was adenomyomatosis with intramural calculi. Except for continuing mild hyperamylasemia, the patient has been doing well for 18 months following surgery. To our knowledge, only two cases, of type B bile duct dilatation with pancreaticobiliary maljunction, including ours, have been reported in the English and Japanese literature. The size of the diverticulum in our case was smaller than in the other reported case. The relationship between pancreaticobiliary maljunction and type B bile duct dilatation is discussed.

Adenomyoma↗
PubMed1993

[Inverted sigmoid diverticulum simulating polyps].

The authors write about the inversion, a rare complication of the diverticulum of the sigmoid colon. The colour, surface of the diverticulum, 15 and 8 mm in diameters, were the same as the colon mucosa, it was soft and mobile by tacting. Biopsy was performed which caused a serious complication, a perforation to the free abdominal space, requiring a surgical operation. The inverted diverticulum can be distinguished from a polyp not by endoscopy, but by double contrast barium enema. Detecting a long, soft, mobile mass in the colon, must be thought about an inverted diverticulum and the biopsy must be omitted.

Colonic Polyps↗
PubMed1995

[Acquired urethral diverticulum in males with spinal cord injury].

OBJECTIVES: To study the clinical features, etiology, diagnostic methods and therapeutic possibilities in male patients with medullary lesion presenting with acquired urethral diverticulum. METHODS: A retrospective study was conducted on patients seen in our department over the past twenty years (June, 1974 to June, 1994) for acquired urethral diverticulum. Ten patients have been treated for the foregoing condition. RESULTS: The etiology of the medullary lesion was traumatic injury in 7 cases and spina bifida in 3 cases. The most frequent cause of the acquired urethral diverticulum was a condom-like urinary collecting device associated with a septic factor. Three patients presented intradiverticular lithiasis. These 3 patients had previous or current lithiasis at other sites of the urinary tract and all of them had a condom-like collecting device. All patients underwent surgery consisting in diverticulectomy and lithectomy, when required. One patient had a recurrence 6 years later because the underlying factors causing the diverticulum were still present. CONCLUSIONS: Personal care and hygiene of patients with medullary lesion is one of the most important factors in preventing urethral injuries. In our view, patient follow-up should include regular radiologic assessment and correct training in the use of condom-like urinary collecting devices and urinary catheters. We advocate one-stage surgical repair with temporary cystostomy, preoperative antibiotic therapy according to the antibiotic profile and culture of symptomatic and asymptomatic urinary infections and the use of methylene blue to ensure the suture is watertight.

Adolescent↗
PubMed1996

[Esophageal diverticulum--perioperative risks and long-term follow-up].

Between 1985 and 1994 36 patients with Zenker's diverticulum were operatively treated by excision of diverticulum and cricopharyngeal myotomy at the University department of Surgery, Mainz. The complication rate was 25% (9 of 36 patients), in 2 cases a suture insufficiency was detectable. Long-term results are based on follow-up studies of 32 patients. The average follow-up interval was 59 (10-101) months, 20 patients (56%) underwent radiological examinations or endoscopy. 29 of 32 patients were totally symptomfree concerning the esophagus. After an average follow-up of almost 5 years there was no symptomatic recurrence. In 1 of 20 radiologically or endoscopically examined patients an asymptomatic recurrence could be detected. These results show that excision of the diverticulum in combination with a cricopharyngeal myotomy is an effective method with low risk for the long-term removal of pharyngoesophageal diverticulum.

Adult↗
PubMed1996

Perforated Meckel's diverticulum in a neonate.

A case of Meckel's diverticulum is reported in an eight-day-old male baby, the youngest patient to have had this condition at National Taiwan University Hospital. The baby had been affected by bilious vomiting of 3 days' duration and abdominal distension before being brought to the hospital. A perforated Meckel's diverticulum was found during emergency laparotomy. The resected Meckel's diverticulum did not contain ectopic tissue. The narrow lumen and narrow base of the diverticulum was thought to be the cause of poor self-emptying and subsequent acute inflammation and perforation.

Age of Onset↗
PubMedDate not supplied

Duodenal diverticulum at endoscopic retrograde cholangiopancreatography, analysis of 123 patients.

BACKGROUND/AIMS: The aim of this study was to investigate the frequency, clinical characteristics, findings and possible varieties of treatment of duodenal diverticula in Finnish patients diagnosed by endoscopic retrograde cholangiopancreatography. MATERIAL AND METHODS: Among 1735 patients investigated by endoscopic retrograde cholangiopancreatography, there were 123 patients with one or more duodenal diverticula and with sufficient clinical data available for this study. Mean age of the patients was 63 years. The male/female ratio was 61/62. Three hundred twenty age and sex matched patients undergoing ERCP during the same time period, but without duodenal diverticula, served as controls. RESULTS: Sixty-one percent of the diverticula were juxtapapillary. Pain and jaundice were the symptoms indicating ERCP in 62% of patients. Laboratory findings were mostly within normal limits. A hepatic or pancreatic tumor was suspected in twelve patients at ultrasound and computer tomography, and five of them had cancer. In 65 patients, both ducts were cannulated at ERCP. In eleven patients, the finding was normal. There was no significant difference in the incidence of pathologic ERCP findings between the patients with juxtapapillary diverticula and diverticula in other parts of duodenum, except pancreatic duct, which was more frequently abnormal in patients with a non-juxtapapillary diverticulum. The patients with juxtapapillary diverticula had not had previous related complications or operations significantly more often than patients with diverticula in other parts of duodenum. The patients with juxtapapillary diverticula had significantly more often biliary stones at ERCP than control patients and they had idiopathic pancreatitis twice as often as control patients, but the difference was not statistically significant. In three patients, the therapy was directed to the diverticulum and 80 patients had some other treatment. CONCLUSION: These data do not reveal any clear correlation between a juxtapapillary diverticulum and pancreato-biliary disorders. However, common bile duct stones were more often found in patients with a juxtapapillary diverticulum than in controls.

Case-Control Studies↗
PubMed1996

Functional and morphological study of the cricopharyngeal muscle in patients with Zenker's diverticulum.

Pharyngo-oesophageal function was investigated in 12 patients with Zenker's diverticulum before and after cricopharyngeal myotomy with or without diverticulectomy using low-compliance, high-frequency oesophageal manometry. Nine healthy volunteers served as controls. The amount of muscle and connective tissue in the cricopharyngeal muscle was also measured by computerized morphometry and compared with findings in cadavers with no history of dysphagia. Preoperative manometry in patients with Zenker's diverticulum showed an incomplete relaxation of the upper oesophageal sphincter (UOS) (the residual UOS pressure at swallowing was 7.9 (range 1-20)mmHg in patients versus 0.2 (-12.5-14) mmHg in controls; P < 0.001) and increased pharyngeal intrabolus pressure (21 (range 0-52) versus 9 (range 0-16) mmHg; P < 0.01), with no pharyngo-oesophageal coordination abnormalities. Both parameters significantly decreased after myotomy. Patients with Zenker's diverticulum had significantly fewer muscle fibres in the cricopharyngeus and the muscle:connective tissue ratio was significantly lower (0.94 (range 0.8-1.4) in patients versus 1.5 (1.4-3.6) in controls; P < 0.05). This study supports the theory that Zenker's diverticulum is caused by an increased intrapharyngeal pressure at swallowing due to incomplete cricopharyngeal muscle relaxation resulting from localized sclerosis.

Adult↗
PubMed1997

A case of Meckel's diverticulum complicated by stenosis of the colon.

Meckel's diverticulum is a common anomaly of the GI tract that is known to cause small intestinal obstruction. A 17-yr-old male who had no history of previous surgery was admitted with intermittent abdominal pain. A barium enema showed extraintestinal compression of the ascending colon, suggesting the existence of a congenital band. Laparoscopy revealed that the ascending colon was lifted up and compressed by the intestinal end of a Meckel's diverticulum with a fibrous band connecting to the umbilicus. The portion of the ileum including the Meckel's diverticulum was resected. This is the first case of stenosis of the colon caused by a Meckel's diverticulum.

Adolescent↗
PubMed1997

[Zenker's diverticulum. External or endoscopic surgery?].

Although the pulsion diverticulum of hypopharynx was first described by A. Ludlow in 1964, the name of the German pathologist F.A. von Zenker is definitively associated with this diverticulum, probably because he was the first to publish a full description of its clinical and pathological aspects. Later, numerous techniques have been described to surgically treat Zenker's diverticulum. However optimal treatment remains controversial. Considering transcervical approaches, microendoscopic CO2 laser diverticulotomy offers comparable functional results. Moreover, this procedure offers the advantages of reduced morbidity, is very short-time consuming and requires a short hospitalization. These last issues should be seriously taken in consideration regarding medical cost. Subsequently, we advocate that microendoscopic CO2 laser diverticulotomy should be considered as first-line treatment option for patients suffering of Zenker's diverticulum.

Endoscopy↗
PubMed1997

[Transoral video-endoscopic esophageal diverticulostomy--a new treatment method for Zenker's diverticulum].

70% of the esophageal diverticula are pharyngoesophageal diverticula. They are caused by a malfunction of the superior esophageal sphincter. Surgical treatment consisted of a myotomy of the superior esophageal sphincter and the resection of the diverticulum through a lateral cervical incision. With the described new endoscopic transoral technique the septum between the diverticulum and the esophagus is divided by a stapling device and both lumina are combined resulting in a esophago-diverticulostomy. At the same time a myotomy of the transverse part of cricopharyngeal muscle and the proximal esophageal wall is performed. Due to the design of the stapling device usually a small pouch remains at the bottom of the diverticulum. A modification of the stapler instrument allowed us to shorten the length of this pouch. The time of the endoscopic procedure is markedly reduced compared to the conventional surgical intervention. There is no necessity for special postoperative wound care and the hospital stay is considerably shortened. Furthermore serious complications like fistulas and lesions of the recurrent nerve, encountered with the open surgical intervention, are avoided. This new technique combines the advantages of a minimal invasive approach and the development of new instruments with the confided principles of the conventional operation in treating the pathogenetical mechanisms of Zenker's diverticulum. To assess the value of the technique long term follow up studies as well as comparative trials will be needed.

Endoscopes↗
PubMed1997

Thoracoscopic treatment of esophagobronchial fistula with esophageal diverticulum.

Thoracoscopic fistulectomy and diverticulectomy for esophagobronchial fistula with esophageal diverticulum were performed on a 49-year-old-woman. The neck of the diverticulum and the fistula were divided with endo-stapling technique. Intraoperative esophagoscopy was found to be useful for the definite localization and complete excision of the fistula and the diverticulum and the avoidance of stenosis of the esophagus. To avoid the recurrence of fistula, a pedicle of viable mediastinal pleura was interposed between esophageal and bronchial closures. Postoperative course was uneventful, and the complete relief of symptom was experienced for a period of 10 months after the operation. It is to be considered that the present thoracoscopic procedure with intraoperative esophagoscopy can be used as a standard operative procedure for esophagobronchial fistula with esophageal diverticulum.

Bronchial Fistula↗
PubMed1997

[Meckel's diverticulum in childhood. The authors' own experience].

Meckel's diverticulum occurs in approximately 2 percent of the population and may present at any age. Although Meckel's diverticulum may produce an intestinal obstruction or perforation, simulating an appendicitis, hemorrhage is its most important clinical presentation. From 1989 to 1994, Meckel's diverticulum was discovered in ten children at laparotomy. Three cases were asymptomatic, representing an incidental finding at laparotomy. Of the seven symptomatic patients, four presented with bowel obstruction (intussusception), three had rectal bleeding one of whom had diverticulitis. Contrast studies--in gastrointestinal hemorrhage--were not helpful in establishing the diagnosis; colonoscopy and gastroscopy ruled out other causes of bleeding. Five of seven symptomatic patients had an intestinal resection while two a diverticulectomy after assessment that the ulcer did not require resection. No postoperative morbidity and mortality is reported in either groups. A Meckel's diverticulum found incidentally at laparotomy should be always resected as the risk of complication is high and that of resection low.

Adolescent↗
PubMedDate not supplied

[Meckel's diverticulum in adults. A 3-decade experience].

OBJECTIVE: To review the prevalence, clinic manifestations and characteristics of the adult Meckel's diverticulum in the Hospital Español de México. BACKGROUND: The Meckel's diverticulum is the most frequent congenital malformation of the gastrointestinal tract. However, only in seldom occasions produces manifestations in adults. METHODS: Retrospective review of 31 years. RESULTS: Meckel's diverticulum was found in only 13 cases. The most common clinical manifestation was pain in the right lower abdominal quadrant; there was not a single case of bleeding. A correct pre surgical diagnosis was done in only one patients. Post surgical course was satisfactory in all patients. CONCLUSION: In adults, the Meckel's diverticulum complications are uncommon, being the most frequent clinical manifestation the pain in the right lower abdominal quadrant and intestinal obstruction.

Adolescent↗
PubMed1998

[Urethral diverticulum complicated with giant lithiasis].

Presentation of one case report of acquired urethral diverticulum in a male with giant urethral lithiasis. Urethral diverticulum are rare entities in males, the condition being more frequent in females. In general, they are acquired in up to 90% cases, the remaining 10% being hereditary Giant urethral lithiasis is also uncommon in our milieu, incidence being higher in Eastern Countries; 4-10% of urethral diverticulum are occupied by lithiasis. Diagnosis is mainly through clinical symptomatology involving the development of a perineal mass or phlegmon; however definite diagnosis is made through CUMS. Management of giant diverticulum in males is by open surgery, preferably a one-step diverticulectomy procedure; in cases such as the reported here, where urethral stenosis or a significant inflammatory involvement of the periurethral tissues is present, a two-step urethroplasty should be preferred.

Aged↗
PubMedDate not supplied

[Intraluminal diverticulum of the duodenum. Report of a case and review of published cases].

The intraluminal diverticulum of the duodenum is very rare; it is an anatomical sac like formation, located in the interior of the duodenum and communicating with it through an orifice situated a the upper pole of the diverticulum where the wall is covered by mucosa on both faces. It has interesting etiopathogenic problems. We present an observation after reviewing the corresponding literature. It was a 32-year old woman suffering from moderate epigastric pains, pyrosis, chronic constipation, markedly nervous. The epigastric pain was unrelated to food or physical efforts. The physical examination showed slight epigastric pain. The gastroduodenal radiological examination showed in the second part of the duodenum a particular image, pear-shaped, homogeneous, impregnated in barium; this image was surrounded by a radiotransparent halo which changed with the patient's position. It has been seen that the diverticulum changes in size and position in agreement with the peristaltism, without ever obstructing the passage through the duodenum. A review is made of the literature and history of intraluminal diverticulum.

Adolescent↗
PubMed1998

Zenker's diverticulum in the elderly: a neurologic etiology?

Though described in 1769, the etiology of Zenker's diverticulum remains unclear. Various primary esophageal motor disorders have been proposed, but no consistent manometric pattern or anatomic etiology has been uniformly recognized. An association with clinical neurologic disease at our institution prompted a review of 12 cases of Zenker's diverticulum in patients over 60 years of age, treated in the last 8 years. Nine patients (75%) underwent cricopharyngeus myotomy and diverticulectomy, with uniformly good results. Ten patients (83%) had an associated neurologic disorder, substantiated by cranial CT or MRI, in most cases. A wide range of neurologic problems were identified, but a strong trend toward brainstem or basilar lesions was present. As expected, the etiology of the neurologic abnormality in most patients in this group was cerebrovascular disease, but two patients had peripheral neuropathies. We suggest that the etiology of Zenker's diverticulum in the elderly may be neurologic in origin. Esophageal motor disorders, including incomplete upper esophageal sphincter opening and increased hypopharyngeal pressures, which may result in Zenker's diverticulum, may be a manifestation of central or peripheral neurologic disease in the elderly.

Aged↗