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PubMed1992

[Gastrointestinal hemorrhage from a duodenal diverticulum].

Duodenal diverticuli are often asymptomatic and are occasionally found during the course of X-ray tests or autopsy. They are sometimes manifested in the form of symptoms related to a complication (hemorrhage, perforation, occlusion). The paper reports a case of gastrointestinal hemorrhage caused by a duodenal diverticulum which was then successfully operated. The Authors affirm that in these cases the resection of the portion of the duodenum with the diverticulum (provided the papilla is not affected) is preferable to direct hemostasis or duodenocephalopancreatectomy.

Aged↗
PubMed1992

[Solitary perforated diverticulum of the right colon. Five cases].

Solitary perforated diverticulum of the right colon is a very uncommon acute disease in emergency surgery, and usually a preoperative diagnosis of acute appendicitis is performed. Five cases of solitary perforated diverticulum of the right colon are presented. Preoperative diagnostic difficulties as well as surgical procedures are discussed.

Adult↗
PubMed2003

[Post-traumatic urethral diverticulum in an adult].

The male urethral diverticulum is a rare affection. The authors report one case of traumatic urethral diverticula. The diagnosis was confirmed by urethrocystography. The postoperative follow-up was good after resection of the diverticulum and urethrography. On the basis of this case, the authors discuss the diagnosis and therapeutic aspects of this disease.

Adolescent↗
PubMed1992

[Congenital diverticulum of the tracheal carina in neonates. A case report].

A 17 day-old neonate with no history of broncho-pulmonary disease presented with a severe respiratory distress which was found to be related to a congenital tracheal diverticulum. An excision of the diverticulum was performed. Histologically it was characterized by a lining wall of stratified columnar ciliated epithelium and the presence of smooth muscle and cartilage in the wall. This rare entity was reported only once in the pediatric literature. It gives a history of chronic respiratory tract infections or acute respiratory distress. Bronchoscopy or bronchography and CT scan are necessary for the diagnosis. The treatment is surgical.

Bronchial Diseases↗
PubMed1992

[Meckel's diverticulum: surgical complications].

A 20-year (1971-1990) retrospective follow-up of all patients with a Meckel diverticulum (MD) out of the Kantonsspital and St. Claraspital Basel is reported. There were 57 men and 34 women with a mean age of 46.7 years (14-89). 60.4% of the cases were occasional findings, 39.6% were symptomatic MD. During the same period of time 5000 appendectomies were performed (ratio diverticulectomy to appendectomy was 1:50). 38.5% of the resections of MD were done when an acute appendicitis was supposed. In one third of the cases the MD was responsible for the symptomatology. Histological findings were 13% unspecific inflammation, 10% perforation, 9.8% ectopic tissue, 6.5% bleeding and 4.3% tumors. 8 out of 36 patients with pathological findings showed postoperative complications (21.6%), the mortality rate was 8.1%. In 55% resected MD without any additional histological findings only one complication (postoperative ileus) (1.9%) was found; mortality was zero per cent. The analysis of these data shows that complications of MD does not only appear in young patients. Complications occur more often in patients with MD with additional ectopy. We recommend the resection of an incidentally discovered Meckel diverticulum.

Abdomen, Acute↗
PubMed1992

[Purulent pleurisy revealing an esophageal diverticulum].

We report a very rare case of a purulent pleurisy which was revealed to be caused by an oesophageal diverticulum. The pleuro-pulmonary infection probably followed the inhalation of septic material which refluxed from an oesophageal diverticulum into the trachea. This was suggested by a barium swallow which showed the transit of the barium into the trachea during swallowing movements.

Anti-Bacterial Agents↗
PubMed2003

[Giant bladder diverticulum presenting as inferior vena cava syndrome].

OBJECTIVES: To report the case of a giant bladder diverticulum clinically presenting with symptoms of inferior vena cava compression. METHODS: Patient under study because of inferior limbs edema who underwent ultrasound that found a giant bladder diverticulum. RESULTS: Diverticulectomy plus adenomectomy were performed. CONCLUSIONS: Acquired giant bladder diverticula are very rare; they should be treated surgically to avoid possible complications.

Aged↗
PubMed1992

[Two cases of pericardial diverticulum].

Two cases of resection of pericardial diverticulum are reported. The lesion was located in the right upper mediastinum in case 1 (66-year-old woman) and at the right anterior cardio-phrenic angle in case 2 (20-year-old woman). In case 1, the shape of the lesion varied on fluoroscopic observation when the position of the patient was changed, and in case 2, ICG instilled into the lesion operation diffused into the pericardial cavity. These procedures seemed to be useful in the diagnosis of pericardial diverticulum, differentiating it from pericardial cyst.

Adult↗
PubMedDate not supplied

Endoscopic management of upper gastrointestinal bleeding from a duodenal diverticulum.

Hemorrhage from duodenal diverticulum is a rare cause of upper gastrointestinal hemorrhage. The side-viewing endoscope was used for almost all cases of diagnosis and endoscopic hemostasis. However, a forward-viewing endoscope is used in emergent endoscopic study for upper gastrointestinal hemorrhage. We report a case in which the endoscopic hemostasis of bleeding duodenal diverticulum was performed during emergent forward-viewing endoscopic study.

Aged↗
PubMed1992

Radiological aspects of Zenker's diverticulum.

In a retrospective study of 143 patients with Zenker's diverticulum followed for a period of 20 years, we classified the diverticula into 4 categories (A, B, C and D) using Brombart's scheme as a basis; the difference between the first two categories, however, was made on the basis of a morphological-dynamic criterion rather than a purely morphological one. Furthermore, a quantitative index was introduced to define the size of the diverticulum. In two cases we noted a substantial increase in volume with the transition from category C to D after more than 3 years, but we were unable to demonstrate an evolution from category A to B, nor from B to C. Our study confirms, on a large scale, the presence of three possible pathogenetic mechanisms, as proposed earlier in the literature: decreased relaxation of the upper esophageal sphincter as the most frequent factor in all categories except category A, and delayed opening or early closing of this sphincter as less frequent factors. The good relaxation of the upper esophageal sphincter in our category A, the different sex ratio and the absence of evolution in this category suggest that category A does not necessarily evolve further.

Adult↗
PubMed2004

[Malacoplakia within a female urethral diverticulum].

OBJECTIVES: We report one case of malakoplakia within a female urethral diverticulum. METHODS: 33-year-old patient who consulted for an asymptomatic vaginal tumor. Physical examination, blood and urine analysis and microbiology tests, as well as urethrocystoscopy and intravenous pyelogram were performed. With the diagnosis of urethral diverticulum we undertook surgical excision through a vaginal approach. RESULTS: Pathology revealed the typical characteristics of malakoplakia within the diverticular lumen. CONCLUSIONS: Malakoplakia is an infrequent inflammatory disease which involves the urinary tract in most cases. Urethra location is exceptional.

Adult↗
PubMed2003

[Zenker's diverticulum in the elderly patient: evolution of endoscopic treatment using a CO2 laser].

OBJECTIVES: The authors report their experience in a retrospective study of 28 patients with symptomatic hypopharyngeal diverticulum. MATERIAL AND METHOD: The mean age was 70 years. Eight patients presented with severe dysphagia and nine with weight's loss. The delay before diagnosis was 17 months. All patients included were studied by an oesophageal barium swallow prior to any treatment. According to Van Overbeeck's classification, diverticula were medium sized in 11 patients, small in 8 and large in 7. All patients had endoscopic assessment of the diverticular pouch; 26 patients were treated by microendoscopic laser myotomy and 2 by resection. RESULTS: The average time for oral feeding was 4 days. None of the 28 cases had a postoperative complication. 25 patients had partial or complete relief of symptoms after their initial treatment. In 3 cases recurrence of symptoms occurred, of whom 2 underwent endoscopic revision and 1 underwent an open procedure. CONCLUSION: Endoscopic laser surgery for Zenker's diverticulum can be recommended as the treatment of choice for elderly patients. It is a useful procedure because it is swift, effective with a low rate of morbidity, even in cases with impaired of health or associated diseases.

Age Factors↗
PubMedDate not supplied

Recurrent hemorrhagic shock from solitary jejunal diverticulum.

We report the case of recurrent hemorrhagic shock manifested by massive melena and hematemesis in a 67-year-old patient, previously operated in another hospital for an abdominal aortic aneurysm two weeks before. During hospitalization the red blood cell scintigraphy was positive for bleeding in the jejunum. Intraoperative endoscopy was performed to identify a solitary diverticulum at the proximal jejunum. Approximately 70 cm of the involved segment was resected by an end-to-end anastomosis. Postoperative one-year evolution has been favorable, without any evidence of rebleeding. A review of the literature concerning this disease indicates the rarity of a massive bleeding from solitary jejunal diverticulum and the need to consider this condition in patients with gastrointestinal hemorrhage.

Aged↗
PubMed2004

[Diverticulum of the submandibular salivary gland ducts].

Examinations of 125 patients with sialolithiasis showed abnormality of the submandibular duct (diverticulum with a sialolith in it) in 3 (2.4%) patients. The authors suggest that diverticulum of the submandibular duct is in fact a variant of its ectasia and can be regarded as a diagnostic nosological entity.

Adult↗
PubMed1992

[Manometric follow-up after resection of Zenker's diverticulum].

Since 1977, 15 patients have undergone surgery for Zenker's diverticula at the University of Würzburg Department of Surgery. We were able to follow up 6 of them after an average of 4 years (5 months to 10.5 years). Preoperative manometric findings available on one patient revealed markedly impaired coordination between pharyngeal contraction and relaxation of the upper esophageal sphincter. After resection of the diverticulum and myotomy of the upper sphincter this was not observed in any of the patients. Myotomy also was followed by significant lowering of resting pressure in the upper esophageal sphincter to mean levels of 18 mm Hg (normally 90-100 mm Hg). By contrast, one patient who did not undergo intraoperative myotomy had only a moderate reduction of resting pressure (to 30-45 mm Hg) and a normal maximum contraction pressure of 100 mm Hg. This patient developed a relapse. Our manometric evidence underscores the importance of intraoperative myotomy as an adjunctive procedure in diverticulum resection. By helping reduce the resistance imposed by interference of impaired coordination with pharyngeal contraction, it also results in a lower rate of relapse.

Aged↗
PubMedDate not supplied

[Laparoscopic management of Meckel's diverticulum].

We present our observations on two young patients with repeated digestive bleeding from hemorrhagic Meckel's diverticulum. In one patient examined by Tc99 scintigraphy, the hemorrhagic area was shown in the lower abdomen. The laparoscopic exploration showed the Meckel's diverticulum at 1 m distance from ileocecal angle. Both cases were treated by resection with a vascular stapler postoperative evolution was favorable.

Adolescent↗
PubMed2004

Small bowel obstruction in an adolescent: a case of Meckel's diverticulum.

Meckel's diverticulum is a relatively uncommon cause of small bowel obstruction in the adolescent population. Here we discuss a patient with clinical and radiographic evidence of a complete bowel obstruction and describe the subsequent operative management. Finally, current literature concerning the diagnosis and management of Meckel's diverticulum is reviewed.

Adolescent↗