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PubMed1978

[Diverticulosis of the small intestine (author's transl)].

The authors report two cases of acquired diverticulae of the small intestine with complications and study of pathological, clinical and therapeutic characteristics of this rare disease. Usually latent, these diverticulae were recognised generally during diverticulitis, intestinal obstruction, perforation or hemorrhage. The treatment was either removal of the diverticulum or segmental resection of the small intestine. Diverticulitis of the terminal ileum may lead to right ileo-colectomy.

Adult↗
PubMed1999

[Colonic diverticulosis and laparoscopy. Analysis of a series of 60 cases].

AIM: This is a retrospective analysis of a series of 60 cases diverticular disease. MATERIAL AND METHOD: From May 1991 to April 1999, 60 laparoscopic colorectal resections were performed for diverticulitis. RESULTS: Conversion to a classical procedure was necessary in 3 patients (5%). There was no mortality and 9 postoperative complications (3 reoperations). The mean length of hospital stay was 9 days, and 6.3 days for patients in whom surgery was performed after January 1998. CONCLUSION: Laparoscopic surgery for diverticular disease is associated with acceptable morbidity and mortality rates and a short median postoperative stay.

Adult↗
PubMedDate not supplied

[Laparoscopic treatment of complicated colonic diverticulosis].

Despite certain controversies over applying a laparoscopic approach to neoplastic pathologies of the colorectum, it seems to be an ideal form of treatment for benign lesions. The Authors have analysed the results of videolaparoscopic treatment in 23 cases of complicated diverticular disease of the colon using their experience of 205 mininvasive colonic operations. Age, sex, diagnosis, time morbidity and type of intervention such as intra and postoperative, length of hospital stay and the parameters that characterise it (length of nasogastric probe, canalisation and restoration of feeding) were the variables considered in both absolute and comparative methods among the various stages of the disease. The aim was to find the best possible treatment. Out of the 23 patients in the study group, immediate recanalisation was impossible in only one case and all interventions were performed according to the predicted video-assisted technique. A partial ureteral lesion was the only single intraoperatory complication found and was intraoperatively repaired by means of transureteral endoscopy. In three cases non specific complication were encountered. The average length of the intervention was 180 minutes, nasogastric tube was taken 3 days, patients passed and start to feed at the 3rd and 4th postoperative day. These data overlap in the various stages of the disease. An adequate preoperatory study and good experience in major laparoscopic interventions resulted in the common difficulties that surgeons might encounter in this pathology to be overcome. We can therefore conclude that based on our results as well as those found in the literature, diverticular disease can ideally be treated with mininvasive surgery.

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PubMed2000

[Percutaneous treatment of calculosis in caliceal diverticulosis: 13-year experience].

We report our experience with the composition and management of caliceal diverticular stones for the past 13 years at our institution. Fourty patients with caliceal diverticular stones were treated percutaneously at Long Island Jewish Medical Center. The size of the diverticula ranged from 1 to 4.8 cm, with a mean size of 2.27 cm. The stone size ranged from 0.2 to 4.5 cm in diameter with an average of 1.7 cm. Twenty patients underwent a metabolic evaluation. Follow-up ranged from 8 months to 140 months with a mean of 72.5 months. We achieved a stone free rate of 95%. All 40 patients were free of pain and infection. The chemical composition of stones was identified in 38 patients. Twelve patients were found to have mainly calcium phosphate stones, 16 mainly calcium oxalate stones, 7 mainly uric acid stones and 3 were found with milk of calcium in their diverticulum. Thirty-five patients had complete resolution of their diverticula with normal urograms. The remaining 5 patients had at least 50% diminution of the diverticulum size. No one of the latter patients was found to have stone recurrence. Metabolic evaluation of the 40 patients showed in the 75% of the cases any metabolic abnormality, an absorptive hypercalciuria type II in two patients (10%), hyperuricosuric hypercalciuria in two cases (10%) and hyperoxaluria in one (5%). Percutaneous management of caliceal diverticular stones is a safe and effective modality compared to the existing alternative procedures reported in the literature.

Adolescent↗
PubMed2000

[Treatment strategy in diverticulosis of the colon].

The results of treatment of 645 patients with diverticular disease of the colon have been analysed. There were 65.4% of women and 34.6%--of men, 54.4% of patients were hospitalized urgently and 45.6% electively. 82.5% of patients underwent conservative treatment, 24.8% of them were operated. In hyperkinetic type of bowel motor activity preference was given to mini-invasive organ-saving operations. In 28 cases Laparoscopic serosa myotomy by Reilly and Hodson were carried out (in 17 cases through miniapproach). In hypokinetic type various types of resection of the colon (20 patients) were performed. In necessity for urgent operation various methods of operations may be made depending on general condition of the patient and extension of the pathologic process. In 29 cases initial resection with anastomosis has been performed. Postoperative complications developed in 20.5% patients. There were no lethal outcomes. In 66 cases 2-stage operations were carried out, lethality being 10.6%, and complications--23.7%.

Aged↗
PubMed2001

[Urethral diverticulosis in women. Analysis of 15 cases].

OBJECTIVE: To evaluate the aetiopathogenic, diagnostic and therapeutic aspects of urethral diverticula in women. MATERIAL AND METHODS: Over a 10-year period (January 1990 to December 1999), 15 patients with a mean age of 36 years (range: 25 to 46 years) with urethral diverticulum were included in this study. The mean parity was 2 with a history of long and difficult delivery in 6 cases. All patients presented lower urinary tract symptoms with a clinical diverticulum on gynaecological examination (14 cases) or on retrograde and voiding cystourethrography (14 cases) or intravenous urography (one case). Diverticulectomy was performed via a transvaginal approach in the dorsal position. RESULTS: There were no postoperative complications. All patients were reviewed with a mean follow-up of 3 years. The urinary symptoms had completely disappeared in 14 cases. One patient was reoperated for recurrent diverticulum. CONCLUSION: Young women with recurrent voiding disorders must be examined for the presence of urethral diverticulum that can be confirmed by cystourethrography. Transvaginal diverticulectomy in the lithotomy position is the operation which ensures the best results.

Adult↗
PubMed2001

[Diverticulosis of the small intestine and massive digestive tract hemorrhage].

The authors present the case-record of a female patient with serious haemorrhage from the digestive tract. A surprising finding of the acute surgical diagnosis and treatment in the stage of compensated hypovolaemic shock were multiple diverticula of the small intestine aborally from the lig. Tretz on the mesenterial side of the intestine. Massive haemorrhage originated in the diverticula of the terminal ileum, haemostasis was achieved by hemicolectomy with resection of the bleeding part of the ileum. The selected surgical treatment is successful on a long-term basis.

Aged↗