Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Diverticulum, Colon”

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 685 records · Page 38Linked to original sources
PubMed1994

The 5-year natural history of complicated diverticular disease.

The natural history of complicated diverticular disease based on details of 300 patients entered into a national audit between 1985 and 1988 is reported. Questionnaires were sent to the general practitioners of 176 patients with this condition 5 years after hospital admission; 120 responded. Of these 120 patients, ten died from recurrent complicated diverticular disease, 29 died from other disorders and 81 remain alive. Forty of 110 patients (excluding those who died from recurrence) are still symptomatic or were so at the time of unrelated death. Thirty-nine patients developed a severe complication after the index admission, 14 of whom had the same complication initially. Of the 77 patients who had initially been managed by sigmoid resection, only two developed recurrent complications compared with 37 of 43 managed conservatively. Of the ten patients who died from recurrent diverticular disease, nine had not undergone sigmoid colectomy at or after the original admission. These data argue for interval sigmoid colectomy in most patients who initially present to hospital with complicated diverticular disease to prevent later development of potentially lethal complications.

Acute Disease↗
PubMed1978

Cancer and "cancer related" colorectal lesions in São Paulo, Brazil.

A series of 832 necropsy specimens were studied grossly with a magnifying lens and all lesions identified were studied microscopically. The age and sex-specific prevalence of adenomatous and hyperplastic polyps is reported and results are compared with those of other populations. A correlation was made between polyps and cancer of the colon and rectum (407 cases). The data suggest that São Paulo is a community in a transitional stage between intermediate and high risk of cancer of the colon. The epidemiologic characteristics of lower rectum cancer are peculiar to some populations and appear unrelated to colon cancer. The black population of São Paulo has a higher prevalence than that reported for African negroes. The data also implicate adenomatous polyps, diverticulosis and hemorrhoids as being probably related diseases.

Adolescent↗
PubMed1995

Laparoscopic-assisted colectomy. The learning curve.

One hundred fifty consecutive laparoscopic-assisted colectomies performed by a surgical team were analyzed in an attempt to define a learning curve. These colectomies performed by the Norfolk Surgical Group over a 24-month period, were divided chronologically into six groups of 25 patients each. The groups were then compared to determine if any improvement in length of procedure, complication rate, conversion rate, or length of stay developed as experience increased. Colon cancer and diverticular disease were the most common indications for surgery in all groups. Right hemicolectomy, left colectomy, and low anterior resection accounted for the majority of procedures in all groups. A significant decrease in mean operative time, from 250 min to 156 min over the first 35-50 cases was observed before leveling off at approximately 140 min for the remaining group. Intraoperative complications were low in all groups (range zero to two) and did not show any trend. There was no statistically significant difference in the conversion rate (23.3% overall) among the six groups. Length of stay decreased from 6 days in the first two groups to 5 days in the last four groups, although the difference was not statistically significant. The learning curve for laparoscopic-assisted colectomies is longer than appreciated by many surgeons, requiring as many as 35-50 procedures to decrease operative time to baseline. Complications can be kept at an acceptably low level while on the curve if a cautious approach is taken and the surgeon realizes that a prolonged operative time is not only acceptable, but appropriate during this long learning process. A conversion rate of 20-25% at any phase of the learning process may in fact represent a limitation of current technology. When combined with a low complication rate it may be the sign of a careful surgeon.

Aged↗
PubMed1993

Gastrointestinal complications in renal transplantation.

One wonders whether the use of cyclosporin, histamine receptor antagonists, low doses of steroids, and early diagnosis and treatment actually modify the incidence, morbidity, and mortality of gastrointestinal (GI) and pancreatic complications in renal transplantation. To find out, we reviewed 614 kidney transplant recipients between January 1984 and December 1988. One hundred patients (16.2%) were found to have GI and/or pancreatic complications in the following distribution: 9.6% gastroduodenal, 1.3% pancreatic, 4% colonic, and 0.4% small bowel. None of the patients presenting a gastroduodenal ulcer had perforation or bleeding. Fifty-five percent of the patients with this complication had a past history of eso-gastroduodenal disease, compared to 19.6% in recipients without gastroduodenal complications. Some 4.4% of the patients had a small bowel or a colonic complication and four died of peritonitis due to bowel perforation. Mortality was 35% in those having intestinal resection and/or perforation with peritonitis. Sixteen percent of patients with colonic complications had a known history of diverticula, compared to 3% for those without colonic complications. The incidence of GI and/or pancreatic complications in renal transplant recipients remains high and has caused 1.1% of the deaths in our series. Mortality is essentially due to upper GI bleeding, peritonitis following perforation, and infectious colitis. Better detection of gastroduodenal and colonic disease before transplantation seems to be mandatory. Prevention with histamine H2 receptor antagonists and early surgical treatment of complicated colonic diverticula help to reduce the morbidity and mortality in kidney graft recipients.

Adult↗
PubMed1991

Diagnostic accuracy of the double-contrast enema for colonic polyps in patients with or without diverticular disease.

The accuracy of the double-contrast enema for the diagnosis of polypoid lesions in the presence or absence of diverticula was evaluated by retrospectively reviewing the medical records of 202 patients subjected to examination and endoscopy. Analysis of the data on 215 polypoid lesions showed that (a) the diagnostic accuracy of the examination is not affected significantly by the presence of diverticula; (b) the sensitivity of the examination is highly dependent on the size of the polyps (smaller or larger than 0.5 cm) but not on the form (sessile or pedunculated); and (c) the positive predictive value is higher in patients without diverticula. The double-contrast enema was confirmed to be a valid method for the diagnosis of polypoid lesions.

Barium Sulfate↗
PubMed1985

False-negative barium enema in patients with sigmoid cancer and coexistent diverticula.

The false-negative rate of barium enema examinations for the recognition of polypoid sigmoid cancer was evaluated in 167 patients with histologically proven carcinoma. The cases were classified according to the coexistence of sigmoid diverticula. In patients with less than 15 diverticula, 3.1% of lesions were missed, while in those with more than 15 diverticula, 20.4% of tumors were undetected. The overall error rate was 7.2%. Extensive diverticulosis is an important factor limiting the sensitivity of barium enema examinations for the evaluation of sigmoid masses.

Aged↗
PubMed1995

Diffuse colonic lipomatosis with giant hypertrophy of the epiploic appendices and diverticulosis of the colon. Report of a case and review of the literature.

PURPOSE: A case of diffuse colonic lipomatosis, dolichosigmoid, hypertrophy of the epiploic appendices and diverticulosis of the colon producing constipation, recurrent sub-occlusive episodes with diarrhea and vomiting, and weight loss is reported. METHODS: Careful preoperative assessment of clinical, radiologic, and endoscopic findings suggested the diagnosis. RESULTS: A total colectomy, followed by a lateroterminal ileoproctostomy, gave complete relief from symptoms. CONCLUSIONS: Of the 12 cases of colonic lipomatosis previously reported, only 2 have isolated involvement of the entire organ, but they do not present lipomatosis of the epiploic appendices.

Adult↗
PubMed1997

Antimesenteric perforations of the colon during diverticular disease: possible pathogenetic role of ischemia.

UNLABELLED: The pathogenesis of free perforations occurring on the antimesenteric border of the pelvic colon during the course of diverticular disease has received little attention, with most being generically referred to as diverticular perforations. PURPOSE: This study was designed to identify the pathogenetic factors responsible for free perforations that may occur in the antimesenteric intertenial area during the course of diverticular disease. METHODS: Vascular alterations of the colonic wall associated with diverticula and open antimesenteric perforations were analyzed. RESULTS: Previous data on the site of diverticula formation and related intramural vascular alterations were confirmed. A subserosal vascular network developed in the antimesenteric intertenial area in instances of multiple bilateral diverticula. Free perforations occurred in the antimesenteric haustral area only with multiple bilateral diverticula. CONCLUSIONS: Alterations of the intramural vascular pattern secondary to the presence of multiple and bilateral diverticula may predispose the colonic wall to acute vascular injury. These changes may be enhanced by an episodic increase of intraluminal pressure and consequent distention of the colonic wall occurring in the course of diverticular disease.

Colon, Sigmoid↗
PubMed1996

Factors influencing bowel function following total abdominal colectomy.

PURPOSE: The purpose of this study was to determine which factors influenced bowel function following total abdominal colectomy. METHODS: Thirty-two patients who had undergone total abdominal colectomy were studied with regard to factors that are classically thought to influence bowel function, namely, residual stump length, transit time, and rectal stump manometry. In a limited subset of patients, anal manometry was done also. RESULTS: Transit time was the best predictor of bowel function following total abdominal colectomy. This was followed by stump length. If transit time was short, then stump length became important in predicting the occurrence of diarrhea following total abdominal colectomy. CONCLUSIONS: Two factors have an important influence on bowel function following total abdominal colectomy: transit time and rectal stump length. Rectal stump length is an anatomic factor that can be controlled by the surgeon. In total abdominal colectomy, rectal stump length of at least 20 cm is necessary if the patient is to have satisfactory postoperative bowel function. This may not always be possible. In these patients, modification of diet to influence transit time and methods to increase rectal compliance will be necessary.

Colectomy↗