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PubMed1994

[Perforated diverticulum of the cecum: conservative therapy or resection?].

The diverticulum of the right colon is a rare disease in Western Countries but is very common in Eastern races. The etiology is usually congenital in the lesions limited to the cecum (true diverticulum). The diagnosis is rarely made preoperatively. The most useful help is from CT and US. Because the clinical features suggest an acute appendicitis, in most cases of appendicectomized patients the intervention is made without any other investigations. At laparotomy, when the diverticulum is surely identified, a conservative treatment is recommended (diverticulectomy or invagination). If there are some doubts an ileo-colic resection is more opportune. After recovery it is useful to study the colon with an Rx clisma.

Cecal Diseases↗
PubMed1995

[Fibroma of the bladder associated with a large diverticulum: a case report].

A 57-year-old woman was admitted with a chief complaint of difficult urination on June 7, 1993. A filling defect and a large diverticulum were revealed on the cystogram. Cystoscopy showed a tumor, obstructing the internal urethral orifice at the bladder neck and a diverticulum at the right posterior wall of the bladder. Under the preoperative diagnosis of a benign bladder tumor with a diverticulum, resection of the tumor and transvesical diverticulectomy were performed by a suprapubic approach. The resected tumor was smooth-surfaced, elastic soft and was measured 2.0 by 1.5 by 1.0 cm in size. Histologically, the tumor was diagnosed as a benign fibroma of the urinary bladder. The postoperative course was uneventful. Non-epithelial benign bladder tumors are rare. To our knowledge, this is the 18th case of bladder fibroma in the Japanese literature. The characteristics of bladder fibroma are briefly described.

Diverticulum↗
PubMed1975

Ectopia cordis with single ventricle and a diverticulum. Exsanguination from septic necrosis of the ductus arteriosus.

An infant is described with partial ectopia cordis and a cardiac diverticulum which orignated from a single ventricle. There was associated deficiency of the lower part of the sternum and lack of pericardial tissue over the diverticulum. These anomalies form part of the midline thoraco-abdominal syndrome in which cardiac anomalies are frequent. The infant died suddenly at 17 days of age owing to haemmorhage from septic ductal necrosis, caused by ascending infection of the tissue between the diverticulum and the thoraci wall.

Autopsy↗
PubMed1994

[Laparoscopic resection of bleeding Meckel's diverticulum].

The most malformations of the gastrointestinal tract are the Meckel's diverticula. In 25% of all complications of this disease you will find a bleeding of the diverticulum. We report a case of a 12 year old boy treated laparoscopically for a bleeding diverticulum and we describe the technical procedure. The first choice in diagnosis in the scintigraphy with 99mTc-pertechnate, at which the proof of ectop stomach mucous membrane is necessary. Laparoscopic resection of a bleeding Meckel's diverticulum performed by an experienced surgeon is a safe and considerate procedure in laparoscopic technique.

Child↗
PubMedDate not supplied

[The perforation of a para-Vater's duodenal diverticulum (a report of 2 clinical cases)].

Duodenal diverticulum is not a rare disease, with a frequency of 1-3% in radiologic review and of 2.8-20% in pathology review; The spontaneous perforation of a perivaterian duodenal diverticulum is a rare complication, with about 100 cases reported in the literature. The post-traumatic perforation of a perivaterian diverticulum is an exceptional event, reported in single cases of the oriental literature. The authors report their personal experience about two cases of diverticular duodenal perforation, one spontaneous, the other post-traumatic, discussing the surgical problems that this rare complication present.

Adult↗
PubMed1976

Urethral Diverticulum in the Female. Etiologic Factors and Postoperative Results.

Among 32 female patients with urethral diverticulum, a high incidence of prior gonococcal infection suggests that periurethral infection with this organism may be a common etiologic factor. The voiding cystourethrogram appears to be the best technic for demonstrating the diverticulum and for differentiating it from other suburethral masses. In the cases not associated with urinary tract infections, local symptoms were uniformly relieved by successful surgical excision. In patients with infection, surgery accomplished clearing of chronic urinary tract infection in 47% and cure of local symptoms in 63%. Persistence of infection following operation calls for further investigation to search for other etiologic factors or the presence of a new or recurrent diverticulum.

Adult↗
PubMedDate not supplied

[Solitary diverticulum of ascending colon induced internal intestinal herniation: report of one case].

Colonic diverticula are generally multiple and occur most commonly in the descending and sigmoid colon. Solitary ascending colonic diverticulum is a rare pathology and presents several features which separate it from colonic diverticulosis. It is a true diverticulum. It is a congenital dysplasia that generally runs an asymptomatic course and becomes clinically important only when inflammatory, perforating, or hemorrhagic complications occurs and presents a difficult problem in diagnosis and management. An unusual case of 4 year old girl with solitary ascending colonic diverticulum was reported here. It caused internal intestinal herniation by forming an adhesion band with mesentery and the clinical course manifested as an acute intestinal obstruction.

Child, Preschool↗
PubMed1993

[Stomach diverticulum. A case report].

The author reports a case of gastric symptomatic diverticulum, not connected to other gastric-biliary-duodenal pathology. The author points out the rarity of diverticulum of the alimentary canal, and points out the symptomatic picture that, in association with a radiologically ascertained diverticulum staunching, represent indications for surgery.

Aged↗
PubMed1993

Dysphagia lusoria: aberrant right subclavian artery with a Kommerell's diverticulum.

A retroesophageal right subclavian artery, the most common congenital aortic arch abnormality, is an unusual cause of dysphagia in adults. The embryologic abnormality of the aortic arch is involution of the fourth vascular arch, along with the right dorsal aorta, leaving the seventh intersegmental artery attached to the descending aorta. This persistent intersegmental artery assumes a retroesophageal position as it proceeds out of the thorax into the arm. Since compression of the esophagus by this right subclavian artery may produce dysphagia, the term "dysphagia lusoria" ("dysphagia by freak of nature"), has been used to describe the symptom complex. The presence of an aneurysm of the artery or Kommerell's diverticulum at its aortic origin is more likely to produce symptoms from esophageal compression. This case presents a middle aged adult with an associated Kommerell's diverticulum and dysphagia. Surgical correction was used to relieve his symptoms and to correct the diverticulum of the proximal right subclavian artery. The embryologic changes that occur are discussed in detail.

Aorta, Thoracic↗
PubMed1995

Meckel's diverticulum: a continuing dilemma?

Forty-three cases of Meckel's diverticulum (MD) encountered in an academic department of surgery over a 15-year period were reviewed. All of the patients and their general practitioners were contacted and long-term follow-up was obtained in 36 cases (85%). In 21 of 35 diverticulectomies, MD was an incidental finding. An overall complication rate of 26% was recorded over an average follow-up period of 8 years. In the asymptomatic group this rose to 30%. None of the eight cases in whom the diverticulum was not resected has developed early or late complications. Our findings suggest that an incidentally discovered Meckel's diverticulum should be left in situ.

Adolescent↗
PubMed1977

[An unusual case of perforation of Meckel's diverticulum].

An infrequent case of puncture of Meckel's diverticulum whose aetiopathogenesis was attributed to a segmentary intestinal dyskinetic phenomenon is reported. The pneumoperitoneum consequent on the puncture was not associated with peritonitis and histology showed that the diverticulum did not show either inflammatory phenomena or areas of ectopic mucosa, namely none of the causes which are usually at the origin of Meckel's diverticulum puncture.

Child↗
PubMed1996

[Leiomyosarcoma in jejunal diverticulum. A case report and review of the literature].

The Authors describe a case of double jejunal diverticulum, characterized by the presence of a leiomyosarcoma in one diverticulum and ectopic pancreatic mucosa in the other. The rarity of the occurrence of a leiomyosarcoma in the diverticular area is outlined; only few cases have been reported in Literature, excluding those originating, from Meckel's diverticulum. Barium X-rays of the small intestine allowed the neoplasia to be discovered, while an Echo-Color-Doppler examination suggested the histological type given the high vascularization typical of leiomyosarcomas.

Diverticulum↗
PubMed1996

Intussusception in an adult secondary to an inverted Meckel's diverticulum.

Intussusception secondary to an inverted Meckel's diverticulum is considered to be a rare occurrence. The pathophysiology of the disease process results in a complicated clinical picture of chronic abdominal pain, lower gastrointestinal bleeding, and recurrent obstructive symptoms that may lead to an unnecessary delay in diagnosis. A case of an inverted Meckel's diverticulum as a lead point for an ileocolic intussusception in an adult is presented. The methods of diagnosis and the salient concepts in the surgical management of intussusception are discussed. Special features regarding the pathophysiology and treatment of an inverted Meckel's diverticulum acting as an intussusception are also reviewed.

Adult↗
PubMed1997

An unusual manifestation of Meckel's diverticulum: bleeding and perforation--a case report.

Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. Bleeding of the diverticulum from a peptic ulcer due to ectopic gastric mucosa makes up 25% of all complications in the disease. We report a case of a 20 year old male with chronic anemia, severe hematochezia and perforation due to Meckel's diverticulum. Segmental small bowel resection was performed. Difficulty of preoperative diagnosis is discussed, indication for incidental diverticulectomy is established and the literature reviewed.

Adult↗
PubMedDate not supplied

[Unusual clinical presentation of Meckel's diverticulum. A case report].

Meckel's diverticulum (Md) is the most common congenital anomaly of the gastrointestinal tract. It results from an incomplete obliteration of the omphalomesenteric duct during fetal life. It is frequently located on the antimesenteric border of the ileum at 80 cm from the ileum-cecal valve. It contains heterotopic mucosa in 30% of the cases and in 70% of these the mucosa is of the gastric type. The most common complication in childhood is represented by hemorrhage. Preoperative diagnosis is often difficult. Barium enema, Tc-99 scintigraphy and selective mesenteric angiography usually can permit diagnosis. In adults occlusion, perforation, diverticulum infection, Littre's hernia and tumors represent the complications of Meckel's diverticulum. A case of Md is reported because of the unusual clinical presentation.

Adult↗
PubMed1997

[Carcinoid tumor in Meckel's diverticulum: case presentation and review of the literature].

Meckel's diverticulum is the most common anomaly of the gastrointestinal tract. Neoplasms are extremely rare. We report a case of carcinoid tumor of Meckel's diverticulum in a patient with acute abdominal pain. So far, 111 cases have been reported. Review of the literature reveals that carcinoids are the most common malignant tumors of Meckel's diverticulum. Two thirds of the patients remain asymptomatic. Metastases are seen in 25% at diagnosis. The probability of metastases depends on the size of the primary tumor. Because of the early metastases rate even in small tumors, aggressive surgical management is justified.

Abdomen, Acute↗
PubMed1997

[Endoscopic treatment of a Zenker diverticulum. 50 cases].

OBJECTIVES: Endoscopy has been used for many years as an alternative to surgery for the treatment of Zenker's diverticulum. We report our experience in 50 cases. METHODS: From 1979 to 1995, we treated 50 cases of Zenker's diverticulum endoscopically. Patients' age ranged from 59 to 98 years. All patients had contraindications for conventional surgery or deep anesthesia. The surgical technique of endoscopic treatment is performed under general anesthesia using a specially designed endoscope for exposure. Scissors, then after 1990, CO2 LASER, was used to divide the posterior crico-pharyngeal muscle fibers. RESULTS: There were no major complications. Our results, 95% success, were comparable with those reported in the literature even though, paradoxically, a small diverticulum may remain. Our experience also showed that it may be necessary to perform two sessions for diverticula larger than 3 cm. CONCLUSION: This safe and efficient treatment can be recommended for patients of all ages with a contraindication for conventional surgery.

Aged↗
PubMed1997

[Echographic diagnosis of female urethral diverticulum].

OBJECTIVE: To describe the utility of transrectal ultrasound as an alternative imaging technique in the diagnosis of diverticulum of the female urethra. METHODS/RESULTS: A 35-year-old female that had been initially diagnosed as having a benign tumor of the vagina is described. The voiding cystogram, positive pressure urethrography with a double balloon catheter and urethroscopy were falsely negative for urethral diverticulum of the female urethra. Subsequent evaluation by transrectal ultrasound disclosed on oval-shaped, anechoic lesion located posteriorly to base of the bladder. CONCLUSIONS: Transrectal ultrasound could be the diagnostic imaging technique of choice in patients suspected as having diverticulum of the female urethra.

Adult↗