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PubMed2002

Recurrent bacterial cholangitis due to a juxtapapillary diverticulum.

We present a patient with recurrent bacterial cholangitis. Endoscopic retrograde cholangiopancreatography did not show evidence for choledocholithiasis or obstructing abnormalities of the common bile duct. However, a juxtapapillary diverticulum was situated at the edge of the papilla of Vater. We postulate that a juxtapapillary diverticulum can obstruct biliary flow due to its anatomical relation with the papilla, which may predispose to bacterial cholangitis. This might be prevented by sphincterotomy of the papilla.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed2002

Laparoscopy-assisted resection of complicated Meckel's diverticulum in adults.

The era of videoendoscopic surgery in emergency surgery practice has facilitated a wide range of endoscopic operative procedures. In our unit the diagnosis of acute abdomen is made after sequential clinical and laboratory examination, and diagnostic laparoscopy is advocated. Laparoscopy-assisted resection of complicated Meckel's diverticulum in two adult patients was performed, and the results are discussed. Between December 1996 and June 2000, 98 patients underwent diagnostic laparoscopy at the Cerrahpasa Medical Faculty Emergency Surgery Unit of Istanbul University because of signs and symptoms of acute abdomen. Among these, we have diagnosed one case of intestinal obstruction due to a volvulus around Meckel's diverticulum and one of acute abdomen masquerading as acute appendicitis but actually involving omphalomesenteric duct cyst torsion. Both of these patients underwent diagnostic laparoscopy and laparoscopy-assisted Meckel's diverticulectomy. Diagnostic laparoscopies were performed on 46 male (47%) and 52 female (53%) patients. In all cases, laparoscopy successfully confirmed the diagnosis. Although in 27 patients the interventions were converted to open procedures, the operations were completed laparoscopically in 71 patients. Two of these patients underwent laparoscopy-assisted Meckel's diverticulectomy and their postoperative periods were uneventful. Both patients were discharged from the hospital on their fourth postoperative day. Diagnostic laparoscopy is a safe and effective method for diagnosis of acute abdomen. In emergency surgery practices in developing countries, advanced laparoscopy should be performed to reduce expenses. Laparoscopy-assisted Meckel's diverticulectomy is a safe and economic procedure and can be performed in adults for treatment of complicated cases without staplers.

Adult↗
PubMed2003

A moving Meckel's diverticulum on Tc-99m pertechnetate imaging in a patient with lower gastrointestinal bleeding.

Meckel's diverticulum is one of the most common causes of lower gastrointestinal hemorrhage in the young. We report a case of a 16-year-old youth who presented with a 3-day history of bright red bleeding per rectum. Clinical examination revealed pallor but nothing else of note. The patient had a hemoglobin of 9 G% on admission. Tc-99m pertechnetate scintigraphy was performed and demonstrated an abnormal focus in the pelvis on the right that changed in position during the course of imaging. A laparotomy was done and a 5 x 2-cm Meckel's diverticulum was removed from the ileum. Histopathologic examination revealed heterotopic gastric mucosa of the body type. The patient recovered fully after operation.

Adolescent↗
PubMed2005

Demonstration of large bladder diverticulum on bone scan.

A 74-year-old man underwent low anterior resection for rectal cancer. Technetium-99m methylene diphosphonate (MDP) bone scanning was performed as part of the patient's postoperative follow-up study. Scans revealed an area of increased tracer uptake in the left hemipelvis. Coronal single-photon emission computed tomography and caudal images clearly separated the lesion from the skeletal structures. Transverse magnetic resonance images showed a large diverticulum originating from the left lateral wall of the bladder. The pelvic findings on the bone scan were the result of tracer retained within this diverticulum.

Aged↗
PubMed2004

Acute ulcerative colitis in a Meckel's diverticulum.

This report describes the case of a patient with acute ulcerative colitis who underwent an emergency colectomy and removal of an incidental Meckel's diverticulum which appeared inflamed. Histology showed acute inflammation of colonic epithelium within the Meckel's diverticulum, justifying its removal and confirming that this was indeed a 'skip lesion'.

Adult↗
PubMed1989

Congenital anterior urethral diverticulum and recurrent urinary tract infection.

A patient with congenital anterior urethral diverticulum is described. He showed recurrent lower urinary tract infection, but he did not have severe upper urinary tract abnormalities. One-stage resection and urethroplasty were successfully performed before the upper urinary tract change developed. Anterior urethral diverticulum should be considered as a cause of recurrent lower urinary tract infection in young children.

Diverticulum↗
PubMed2004

Rupture of urachal diverticulum in radiation cystitis and neurogenic bladder dysfunction after radical hysterectomy.

We experienced a rare case of the rupture of the urachal diverticulum in radiation cystitis and neurogenic bladder after radical hysterectomy. A 61-year-old woman presented with severe lower abdominal pain and urinary retention. Abdominal computed tomography revealed that the urachal remnant contained a large volume of urine that leaked to subcutaneous tissue. We excised the urachal diverticulum and bladder together and created a continent urinary diversion using transverse colon. Nine months after the operation, the patient could manage clean intermittent self-catheterization 6 times a day through her umbilical stoma without any urinary complications.

Cystitis↗
PubMed2006

Acute urinary retention as a result of a bladder diverticulum.

An 11-month-old infant presented with acute urinary retention. He had presented 3 months earlier with complaints of an enlarging abdominal mass that was initially diagnosed as a mesenteric cyst on ultrasonography. Voiding cystourethrogram revealed a large bladder diverticulum. Bladder diverticulum should be a differential diagnosis in children, especially male, presenting with urinary retention, fever and an abdominal mass.

Acute Disease↗
PubMed2006

Outcome and quality of life after open surgery versus endoscopic stapler-assisted esophagodiverticulostomy for Zenker's diverticulum.

Two techniques for treatment of Zenker's diverticulum, endoscopic stapler-assisted esophagodiverticulostomy and open cricopharyngeal myotomy by transcervical approach, were compared with regard to patient satisfaction and quality of life. Between January 1994 and December 2004 a total of 47 patients with Zenker's diverticulum underwent surgery in our department. Besides the usual retrospective evaluation of details of surgery, all patients were sent a questionnaire on their actual complaints and quality of life according to the Gastrointestinal Quality of Life Index (GIQLI). Twenty patients had the endoscopic procedure (Group A), and 27 the open procedure (Group B). The preoperative symptoms were dysphagia in 96%, regurgitation of undigested food in 60%, cough in 19%, and pneumonia caused by recurrent aspiration in 9%. The length of surgery was on average 32 min (range 5-70 min) in Group A and 106 min (range 45-165 min) in Group B, and the length of hospital stay was 5.5 days (range 1-10 days) and 12.3 days (range 7-25 days), respectively. The results of the questionnaire showed that the preoperative symptoms had disappeared in up to 83%, and 91% in Group A and 100% in Group B would be willing to undergo surgery again. The mean GIQLI was 123 points in Group A and 118 points in Group B (healthy volunteers in the literature, 125 points). Both techniques showed good results in a long-term follow-up with regard to relief of symptoms and patient satisfaction. Both groups had an excellent Gastrointestinal Quality of Life Index, comparable to that of a healthy standard population.

Aged↗
PubMed1980

Perforated leiomyosarcoma of Meckel's diverticulum.

A case is reported of perforated leiomyosarcoma of Meckel's diverticulum. The patient presented with localized peritonitis which responded to antibiotic therapy, and diagnosis was not made until elective resection of a tubulovillous adenoma of the rectum which was found in the course of investigation. Although rare, leiomyosarcoma is the commonest malignant tumour of Meckel's diverticulum.

Aged↗
PubMed1985

Ileocaecal intussusception of a previously recognized Meckel's diverticulum.

A case is reported of an ileocaecal intussusception caused by a previously recognized Meckel's diverticulum. The case offers the opportunity to discuss the management of an asymptomatic Meckel's diverticulum found incidentally. The conclusion is reached that, in general, diverticulectomy is appropriate.

Adult↗
PubMed1975

Anterior urethral diverticulum in the male: report of two cases.

Anterior urethral diverticulum in the male is relatively uncommon; 2 additional cases are presented. One of the patients had a unique fusiform dilatation of the urethra, the first to be reported in an adult as an acquried diverticulum. Features distinguishing acquired from congenital urethral diverticula are discussed.

Aged↗
PubMedDate not supplied

Surgical repair of an intrathoracic esophageal pulsion diverticulum in a horse.

An intrathoracic esophageal pulsion diverticulum causing repeated episodes of esophageal obstruction in a Morgan weanling colt was diagnosed by endoscopy, positive contrast radiography, and pleuroscopy. Surgical excision of the diverticulum alleviated clinical signs, and the horse was able to resume a normal diet by day 6. After 9 months the colt remains asymptomatic.

Anesthesia, General↗
PubMed1989

Diagnosis of coronary sinus diverticulum in Wolff-Parkinson-White syndrome using coronary angiography.

The entity of Wolff-Parkinson-White Syndrome and coronary sinus diverticula when the bypass tract is posteroseptal in location has been described recently. The presence of this diverticulum may complicate arrhythmia surgery and could potentially add to the risk of catheter ablation. We describe a case of Wolff-Parkinson-White Syndrome in which the diagnosis of a coronary sinus diverticulum was made preoperatively using late-phase coronary angiography and suggest angiography be considered in patients with posteroseptal bypass tracts prior to surgery or catheter ablation.

Adult↗
PubMed1991

Low energy catheter ablation of a posteroseptal accessory pathway associated with a diverticulum of the coronary sinus.

A 23-year-old man was resuscitated from ventricular fibrillation and subsequently shown to have the Wolff-Parkinson-White syndrome. Electrophysiological study demonstrated a posteroseptal accessory pathway, and coronary sinus angiography demonstrated that this was associated with a diverticulum of the coronary sinus. Catheter ablation was performed using a new low energy system. Five shocks were delivered within the coronary sinus diverticulum, with a cumulative energy of 39 joules (J). Accessory pathway conduction was blocked successfully, and there were no complications.

Adult↗
PubMed1999

Catheter ablation in a patient with a congenital giant right atrial diverticulum presented as Wolff-Parkinson-White syndrome.

A young woman symptomatic for tachycardia showed right ventricular preexcitation on the surface ECG with a pattern during induced atrial fibrillation suggestive of multiple APs. Noninvasive imaging techniques performed prior to catheter ablation demonstrated the presence of a giant right atrial diverticulum confirmed by hemodynamic procedure. This structure functioned as an enormous accessory AP. We performed catheter ablation of this pathway using a special 4-mm multipolar catheter inside the diverticulum. This is the first case of such as anomaly being successfully treated with catheter ablation.

Adult↗
PubMed2005

Radiofrequency ablation of a concealed right anterior accessory pathway associated with right atrial diverticulum in a child.

A 9-year-old boy had refractory supraventricular tachycardia and a right atrial (RA) diverticulum as diagnosed by ultrafast computed tomography. An electrophysiological study under transesophageal echocardiography guidance revealed a concealed right anterior accessory pathway passing through the body of the RA diverticulum. Radiofrequency ablation was performed to eliminate retrograde ventriculoatrial conduction.

Catheter Ablation↗