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PubMed1991

A case of congenital left ventricular diverticulum with pulmonary stenosis and its scintigraphic characteristics.

We encountered a 31-year-old female patient with mild valvular pulmonary stenosis who had no abnormality in the electrocardiogram but pulmonary dilatation in the chest radiograph. Two-dimensional echocardiography and magnetic resonance imaging demonstrated two small protrusions at the interventricular septum indicating diverticula. Large perfusion defects were observed at the anterior wall in the thallium-201 myocardial tomograms. Short axial and vertical long axial images by ECG-gated blood pool tomography revealed an out-pouching best seen during diastole and a good contraction during systole in the corresponding areas. These findings suggested the presence of thin but normal myocardium in the anterior wall, i.e. a muscular type of left ventricular diverticulum. The presence of the muscular type of left ventricular diverticulum at the anterior and septal walls was confirmed by contrast left ventriculography. A congenital diverticulum at the anterior and septal walls with pulmonary stenosis is very rare. Furthermore, its scintigraphic images were quite characteristic and useful for its diagnosis.

Adult↗
PubMed2001

Pyelocalyceal diverticulum: the imaging spectrum with emphasis on the ultrasound features.

Clinical and imaging data of 11 patients with pyelocalyceal diverticulum were retrospectively examined. Four patients suffered from ipsilateral flank pain, one from recurrent urinary tract infection and the other six from unrelated symptoms. All patients underwent ultrasound as the initial imaging study. In two cases ultrasound was the only examination performed. Additional imaging studies were obtained in the other nine patients (abdominal radiography in six cases, intravenous urography (IVU) in five and CT in four). Ultrasound suggested the diagnosis of pyelocalyceal diverticulum in eight cases owing to the presence of echogenic and mobile material within the cyst-like lesion. In three cases the ultrasound appearance was similar and indistinguishable from a simple cyst and the diagnosis was made by another imaging study IVU in two cases and CT in one). We suggest that ultrasound examination is the best imaging method for the diagnosis of a pyelocalyceal diverticulum, and no further imaging modalities are required when mobile echogenic material is seen. In uncertain cases, another relatively inexpensive imaging study should be added such as abdominal radiography or IVU.

Abdominal Pain↗
PubMed1977

Hypopharyngeal diverticulum.

The diagnosis and surgical management of 26 patients with hypopharyngeal diverticulum treated in the Department of Otolaryngology of the Washington University Medical School from 1961 to 1973 is discussed. The surgical technique for external excision of the diverticulum is described in detail. Results and complications are presented. The surgical excision of hypopharyngeal diverticulum is a standard, safe, and proven method of management which can be expected to result in satisfactory long-term results with minimal morbidity.

Adult↗
PubMed2006

Epiphrenic esophageal diverticulum after laparoscopic placement of an adjustable gastric band.

A morbidly obese woman (BMI 56 kg/m2) in 1998 underwent laparoscopic placement of an adjustable gastric band by the perigastric approach. 5 years later, she complained of reflux and weight regain. X-ray with contrast revealed pouch dilatation. She subsequently underwent a laparoscopic revision including retrocardia band replacement using the pars flaccida technique. During the further course, an epiphrenic diverticulum was diagnosed. Because of danger of perforation of the large thin-walled diverticulum and the esophageal motility disorder, the band was laparoscopically removed and the diverticulum was resected via a transhiatal approach. This case presents a very rare complication after placement of a gastric band and its successful management.

Device Removal↗
PubMed1992

Congenital diverticulum of the ileum in a rat.

A congenital diverticulum of the ileum (Meckel's diverticulum), approximately 10 mm long, was detected in a rat and examined histologically. The histological findings were basically the same as in the ileum. Although Meckel's diverticulum is uncommon in the rat, the present report demonstrated the possibility of discovering new cases.

Animals↗
PubMed2003

A congenital left ventricular diverticulum combined with a complex malformation syndrome.

Congenital left ventricular diverticulum is rare and usually isolated or associated with midline thoracoabdominal defects and other congenital cardiac malformations. We describe a case with a previously undescribed malformation syndrome including bilateral obstruction of the ureteropelvic junction, agenesis of corpus callosus, scoliosis, hip dysplasia, severe developmental delay, failure to thrive and congenital left ventricular diverticulum but with normal GTG-banded karyotype. The cardiac lesion was suspected on echocardiography and was confirmed by cineangiography, which outlined a huge apical diverticulum opening through a wide ostium into the left ventricular cavity. To our knowledge this case report is the first description of an association with such a malformation syndrome.

Corpus Callosum↗
PubMed1980

Giant colonic diverticulum.

Five patients with giant colonic diverticulum (GCD) are reported. Three of them had complications of the GCD including free perforation with pneumoperitoneum and peritonitis and an instance of carcinoma arising in a GCD. The preoperative diagnosis of GCD is made radiographically with findings of a large, smoothly marginated, round or oval, homogenous radiolucency in the abdomen that is in close apposition to the colon on barium enema examination. Barium enters the GCD in 60% of the cases. Most GCDs are considered to be pseudodiverticula; however, an occasional case may have all layers of bowel in the wall of the diverticulum and is believed to represent a true diverticulum or a communicating partial colonic duplication.

Adult↗
PubMed2005

Urethral diverticulum: diagnosis with virtual CT urethroscopy.

OBJECTIVE: A 26-year-old woman presented with urinary frequency. Findings were negative on voiding cystourethrography. Cystourethroscopy failed to reveal a urethral diverticulum. A new method of virtual CT urethroscopy was performed using a 16-MDCT scanner. The orifice of the diverticulum was identified clearly on 3D virtual urethroscopy. Intraoperatively, the diverticulum was identified, with the orifice location compatible with that seen on virtual urethroscopy. CONCLUSION: Virtual CT urethroscopy provides more information than conventional urethral examinations and is less invasive than conventional urethroscopy.

Adult↗
PubMed1996

Zenker's diverticulum--a historical review and trends in therapy.

More than 200 years have passed since the pulsion diverticulum of hypopharynx was first described. This paper reviews different opinions on its etiology over the centuries. The German pathologist F.A. von Zenker, who successfully pursued research on a variety of topics, is often associated with this diverticulum through his classical work from 1867 "Krankheiten des Oesophagus", which deals with the pathogenesis and clinical presentations of this herniation of the posterior mucosal wall. Numerous surgical techniques, which have been practised mainly during this century, are also reviewed. Different options of endoscopic surgery, which is presently the preferred approach at many medical centers, are described and discussed. Our own experience of endoscopic surgery in patients with Zenker's diverticulum is also presented.

Endoscopy↗
PubMed1992

No significant correlation between histologic changes of the papilla of Vater and juxtapapillary diverticulum. Special reference to the pathogenesis of gallstones.

The aim of this study was to investigate the significance of histologic changes of the papilla of Vater in cases with a juxtapapillary diverticulum, with special reference to the pathogenesis of gallstones. Three hundred and sixty-two autopsy cases, mainly of aged people, were analyzed. The incidence of both diverticulum and gallstone increased with age. The presence of diverticulum was associated with a significant increase of gallstones (49% versus 20%; P < 0.01). Analysis by the type of gallstones showed a significantly higher incidence of bilirubinate in cases with juxtapapillary diverticula. Stones both in the gallbladder and in the extrahepatic bile ducts were more prevalent in cases with diverticula as compared with the cases without diverticula. No significant relationship was found between juxtapapillary diverticula and the degree of histologic changes in the papilla of Vater, such as inflammatory cellular infiltration, fibrous proliferation, glandular proliferation, or muscular hypertrophy and proliferation of the sphincter of Oddi. These facts imply that juxtapapillary diverticula are not involved in the formation of gallstones via histologic changes of the papilla of Vater, whereas diverticula may play an important role in the pathogenesis of gallstones, especially of bilirubin stones.

Aged↗
PubMed1983

Diverticulum of the lateral ventricle causing cerebellar ataxia. Case report.

A case of ventricular diverticulum causing cerebellar ataxia is presented. Computerized tomography clearly demonstrated the aperture of the diverticulum in the medial wall of the trigone and its extension into the posterior fossa. The diverticulum regressed and the cerebellar ataxia disappeared after placement of a ventriculoperitoneal shunt.

Brain Diseases↗
PubMed2002

Incidentally found pharyngoesophageal diverticulum on ultrasonography.

The pharyngoesophageal diverticulum in the lower part of the neck can be detected using neck ultrasonography. We present a case of pharyngoesophageal diverticulum mimicking a thyroid nodule, which was found incidentally by ultrasonography, and discuss its peculiar findings, which might be useful to diagnose pharyngoesophageal diverticulum and to prevent invasive procedures such as needle aspiration biopsy.

Aged↗
PubMed2004

Giant Meckel's diverticulum associated with a congenital diaphragmatic hernia.

Giant Meckel's diverticulum is a very rare lesion and its association with a congenital diaphragmatic hernia has not been reported previously. We report a case of newborn with a giant Meckel's diverticulum and congenital diaphragmatic hernia. A large round atypical air-filled bowel segment was found by chest radiography preoperatively, and a giant Meckel's diverticulum was located within the left hemithorax during surgery.

Hernia, Diaphragmatic↗
PubMed1988

Position of Meckel's diverticulum in broiler-type chickens.

In each of three trials broiler-type chickens were used to determine whether Meckel's diverticulum resides in a constant position along the intestinal tract. Chickens were provided a basal diet ad libitum through 49 (Trials 2 and 3) or 52 days of age (Trial 1). Body weight and total intestine length as well as the lengths of the intestine from the gizzard to Meckel's diverticulum (GMD) and from Meckel's diverticulum (MD) to the cecal openings (MDC) were then recorded. When intestine length was expressed as a percentage of body weight, significant differences were noted between sexes. However, no significant differences were observed between sexes for either GMD or MDC relative to total intestinal length. Results of this study indicate that MD resides in a constant position along the length of the intestinal tract. This constancy of position supports the use of MD as a boundary point of the intestine.

Animals↗
PubMed2002

A carcinosarcoma/sarcomatoid carcinoma arising in a urinary bladder diverticulum.

We describe an invasive polypoid carcinosarcoma/sarcomatoid carcinoma arising within a urinary bladder diverticulum in a 65-year-old patient with synchronous, moderately differentiated prostatic adenocarcinoma. Histologically, the diverticular tumor exhibits an admixture of different morphologic components, including invasive high-grade urothelial carcinoma, malignant glandular structures in a cellular background of malignant spindle cells, and areas formed exclusively by spindle and pleomorphic cells. There was full-thickness involvement of the diverticulum with extension of the tumor into the perivesical fat and ipsilateral seminal vesicle. In view of the early invasive behavior of carcinosarcoma/sarcomatoid carcinoma combined with the paucity of the muscular layer in the diverticulum wall, a graver prognosis was expected for this aggressive tumor that occurred in this unusual site.

Adenocarcinoma↗
PubMed1989

[The role of uninhibited bladder in antireflux surgery. Special reference to reflux recurrence and diverticulum formation].

A retrospective study on antireflux surgery for primary vesicoureteral reflux at Hokkaido University Hospital was performed. One hundred and seventy-nine patients (299 ureters) underwent antireflux surgery in these 17 years and 7 months. When the period was divided into 3, success rate was 96.5, 93.8 and 100 per cent, respectively. Overall success rate was 96.6 per cent. There was a combined failure or complication in 9 patients. The records of these 9 were reviewed in detail. Three were believed to be a technical error: 2 stricture and one persistent reflux. The remaining 6 were all children except one and had no clear reason for failure: 2 persistent reflux and 4 contralateral appearance of reflux ("missing VUR"). Four of these 6 patients were characterized by voiding dysfunction, namely uninhibited bladder. In 3 patients reflux disappeared spontaneously by administration of anticholinergic agent. In many of these, vesical diverticulum formation was also noted to precede or to coincide with recurrence or appearance of reflux. Thus other 3 patients with diverticulum formation after antireflux surgery were added and re-evaluated. All 3 children had voiding dysfunction with uninhibited bladder. Diverticulum formation was believed to be related to uninhibited bladder in at least one child. It seems that the child with uninhibited bladder and reflux is particularly at risk for failure or complication of antireflux surgery. Patients with symptoms of voiding dysfunction deserve a complete evaluation, including cystoscopy and urodynamics.

Child↗
PubMed1996

Giant sigmoid diverticulum.

A 49-year-old man was seen with an unusual complication of diverticulitis--a giant sigmoid diverticulum. This patient had undergone an extensive workup during a 5-year period, ranging from multiple extensive gastroenterology evaluations and procedures to an eventual psychiatric evaluation to rule out the possibility of a functional cause for his chronic, intermittent abdominal pain. Later, an accurate diagnosis of a giant sigmoid diverticulum resulted in an en bloc resection of the sigmoid colon and cyst. The patient had an uncomplicated recovery with no return of his previous symptoms. The authors review the many proposed causes of the giant sigmoid diverticulum and possible differential diagnoses. Initially, the diagnosis is usually missed as plain roentgenograms, upper and lower gastrointestinal x-ray studies, and computed tomography scans generally show no abnormality. Management methods are also discussed.

Colon, Sigmoid↗
PubMed1997

Excision of urethral diverticulum calculi in a pregnant patient on an outpatient basis.

Although the incidence of urethral diverticula in women of reproductive age ranges from 0.6% to 6%, urethral diverticulum calculi are rarely reported. This report describes excision and outpatient management of urethral diverticulum calculi in a symptomatic pregnant patient. The etiology, diagnosis, and recommended therapy of urethral diverticulum calculi are discussed. Historically, surgical therapy has been considered appropriate; however, recent technologic advancements--including ultrasound and lithotripsy--may change this widely accepted method of treatment.

Adult↗