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PubMed1987

[Congenital diverticulum of the lower choledochus. Apropos of a case with intraduodenal development].

The onset of subicterus in a patient revealed the presence of a congenital diverticulum of lower common bile duct of intraduodenal development. A part from the rarity of this lesion this case is of interest due to the complete range of ultrasound, endoscopic and CT scan imaging performed, the association of a common mesentery and the surgical technique employed. The latter comprised exeresis by transduodenal approach and a side-to-side choledocho-duodenal anastomosis through the intermediary of the diverticular sleeve. The nosology and differential diagnosis of diverticulum of lower common bile duct are discussed and data from a literature review used to describe diagnostic, etiopathogenic and histopathologic aspects as well as complications and treatment of this type of congenital dilatation of lower biliary tract.

Common Bile Duct Diseases↗
PubMed1987

[Esophageal diverticulum--indications for surgical therapy and late results].

63 cases of oesophageal diverticulum were analysed, and surgical therapy was chosen for 45 of them. Most of them were located in the cervical region of the oesophagus (44.4 per cent). Cervical and intrathoracic diverticula or those causing pain and possible bleeding were indications for surgical treatment. No postoperative complications occurred to the above patients. Recurrence was observed in three of 28 cases, following surgery for Zenker's diverticulum. No complaints at all were recordable from 79 per cent of the patients in follow-up checks after surgery.

Adult↗
PubMed1979

[Diagnosis of a Meckel's diverticulum (author's transl)].

In diagnosing a Meckel's diverticulum besides the conventional plain films of the abdomen with and without contrast and the angiographic special attention is called to the scanning with technetium. This examination can be very helpful in cases of children with gastrointestinal bleeding episodes in the diagnosis of a Meckel's diverticulum, if it contains ectopic gastric mucosa.

Adolescent↗
PubMed1988

Carcinoma in a true diverticulum of the gallbladder.

Extensive search of the literature reveals the extreme rarity of true diverticulum of the gallbladder. Its frequency varies from 0.0008% of all resected gallbladders at the Mayo Clinic to 0.06% of a series of congenital anomalies of the gallbladder collected from the world literature. We are presenting a case of a true diverticulum of the gallbladder with sonographic demonstration and focal malignant alterations, neither one of which has been reported previously. The difference between true and false diverticula of the gallbladder is discussed.

Diverticulum↗
PubMed1988

Esophageal leiomyoma arising in an epiphrenic diverticulum.

A 32-year old woman was found at surgery to have an esophageal leiomyoma arising within an epiphrenic diverticulum. These uncommon conditions may rarely occur together, causing difficulty in diagnosis of the leiomyoma. Other neoplasms may also arise in an epiphrenic diverticulum and should be borne in mind in this situation.

Adult↗
PubMed1988

[A case of stone-containing pyelocaliceal diverticulum managed by percutaneous technique].

We report a case of stone-containing pyelocaliceal diverticulum which was successfully managed by a percutaneous technique. Percutaneous management of pyelocaliceal diverticulum is discussed and four important points are stressed: 1) direct puncture is best, 2) the operation should be done carefully because a safety wire cannot be placed in most cases, 3) augmentation and stenting of the ostium are necessary and 4) shrinkage may be facilitated by the use of electrofulguration.

Adult↗
PubMed1988

[Congenital vesical diverticulum in a child].

A case of congenital vesical diverticulum in childhood is reported and 28 other cases in children from the Japanese literature are reviewed. A 9-year-old boy presented with hematuria and two-phase micturition. Excretory urogram and voiding cystourethrogram showed a diverticulum of the bladder on the left side and left vesico-ureteral reflex. Diverticulectomy and left ureteroneocystostomy (by Paquin's method) were performed. Post-surgical recovery was very good. All 28 cases we reviewed were in males whose average age was 6 years and 2 months. Their chief complaints consisted of dysuria, urinary infection and hematuria. The two-phase micturition appeared to be rather rare.

Child↗
PubMed1988

[A case of female urethral diverticulum calculi].

A 53-year-old nulliparous woman complained of terminal pain on urination and bended micturition. Previously, she had been treated unsuccessfully with antibiotics for chronic cystitis. On examination, a mass of approximately a thumb's head-size, was palpated at the left portion of urethral meatus. Plain film of the pelvis revealed stones under the margin of symphysis pubis. Positive pressure urethrography revealed a diverticulum slightly larger than the stones. Transvestibular diverticulectomy and urethrolithotomy were performed without any postoperative complications. In Japan, 38 cases of diverticulum calculi of the female urethra have been reported.

Diverticulum↗
PubMed1988

Female wide urethra masquerading as a urethral diverticulum in association with ectopic ureterocele.

A rare case of wide urethra in a female infant mimicking as a urethral diverticulum in association with ectopic ureterocele is reported. The ureterocele terminated just below the bladder neck, but the diverticulum-like structure everted from the wide urethra, protruding towards the ureterocele. Weakness of the urethral wall, distal to the actual ureterocele may produce such an abnormal radiologic finding. The pertinent literature is reviewed.

Diagnosis, Differential↗
PubMed1979

Meckel's diverticulum. Vagaries of technetium scanning.

A case of a Meckel's diverticulum is described in a young man presenting with abdominal pain and gastrointestinal bleeding. Methods of arriving at the diagnosis preoperatively are reviewed. A false-negative as well as a true-positive small bowel series and technetium scan were obtained in this case. The factors influencing technetium uptake by a Meckel's diverticulum are reviewed.

Abdomen↗
PubMed1988

[Radiological diagnosis of Meckel's diverticulum].

Seven patients with clinically suspected Meckel's diverticulum were examined. The symptoms of Meckel's diverticulum are variable, ranging from mild recurrent or severe acute gastrointestinal bleeding to intestinal obstruction and acute peritonitis. The authors evaluate the diagnostic results and suggest guidelines to choose the most appropriate radiological procedures, according to the clinical pattern: barium meal, enteroclysis and scintigraphy (99mTc) in patients with mild bleeding; mesenteric angiography in case of severe bleeding. The possibility of false negatives and positives is then discussed.

Acute Disease↗
PubMed1977

Radionuclide diagnosis of bleeding Meckel's diverticulum in children.

The preoperative diagnosis of rectal bleeding due to Meckel's diverticulum in children has major difficulties when only standard clinical and radiographic technics are utilized. During the past three years we have done 70 studies with Tc99m pertechnetate for this suspected diagnosis using scintillation camera imaging and computer analysis. Five positive cases were identified and all verified at surgery. No false positives were noted. We believe this to be a safe and available procedure that should be considered a primary diagnostic modality in the investigation of young children with suspected bleeding Meckel's diverticulum.

Child↗
PubMed1985

Atresia of the foramen of Monro resulting in severe unilateral hydrocephalus with subfalcial herniation and infratentorial diverticulum.

A case of severe unilateral hydrocephalus associated with ventricular diverticulum and subfalcial herniation secondary to likely atresia of the foramen of Monro is presented. Both atresia of the foramen of Monro and ventricular diverticulum are rare conditions in hydrocephalus. The case presented here is the third reported case with both unique entities.

Cerebellar Diseases↗
PubMed1985

Esophageal web associated with Zenker's diverticulum: a possible cause of continuing dysphagia after diverticulectomy.

A 67-year-old man with upper esophageal dysphagia thought to be caused by a large Zenker's diverticulum was found to have esophageal web at the time of diverticulectomy and cricopharyngeal myotomy. The web was divided by sharp dissection. Untreated, this thin web would almost certainly have resulted in dysphagia postoperatively. The authors therefore recommend routine open diverticulectomy for the management of Zenker's diverticulum, to allow inspection of the esophageal lumen for concomitant disease and palpation of the cricopharyngeal muscle at the time of myotomy.

Aged↗
PubMed1985

[Stone-containing pyelocaliceal diverticulum: a case report].

We report a case of stone-containing pyelocaliceal diverticulum. A 68-year-old man was admitted for extensive investigation of microscopic hematuria on January 12, 1983. A cluster of numerous small calcifications was disclosed in the left renal region on an abdominal plain film and the case was considered to be of stones in the left kidney. An excretory pyelogram showed that the stones were away from the collecting system of the left kidney. Through partial nephrectomy, 107 stones were removed on January 21, 1983. Histological examination of the surgical specimen revealed pyelocaliceal diverticulum. The stones were found to consist of calcium oxalate and calcium phosphate by infrared spectrophotometry. In addition to these components, a small amount of magnesium was detected by X-ray microanalysis. A scanning electron microscopic study of the cut surface of the stones disclosed the presence of a granular core identified as urate and calcium oxalate, concentric laminations of crystallized substances in the mid-zone and laminations of amorphous substances in the outer layer.

Aged↗
PubMed1979

Carcinoma of Meckel's diverticulum.

Acute intestinal obstruction in a women, aged 56, was caused by a highly malignant adenocarcinoma arising in a Meckel's diverticulum. Despite radical surgery, the tumour recurred after four months, and the patient died nine months after her first operation. This confirms the general bad prognosis associated with carcimomas of Meckel's diverticulum.

Adenocarcinoma↗
PubMed1979

[Meckel's diverticulum and its complications].

In the last 8 years 15 cases of Meckel's diverticulum were observed, 6 of them with complications: three times inflammation (with two perforations), each once invagination, incarceration and occult bleeding from carcinoids. All complicated and 7 bland diverticula were removed and the intestine oversewed. The postoperative course was normal. Two cases were not treated. Considering possible complications it is recommended to search for a Meckel's diverticulum at each uncomplicated appendectomy or inferior laparotomy and to remove it if found.

Adolescent↗
PubMed1984

Meckel's diverticulum: pitfalls in scintigraphic detection in the adult.

The diagnosis of a bleeding Meckel's diverticulum containing ectopic gastric mucosa by 99m-Tc pertechnetate imaging is reported to have a diagnostic accuracy of 90% for patients in the pediatric age group. The usefulness of Meckel's scanning in adults is, however, less certain. We present two patients who illustrate some of the difficulties inherent in Meckel's scanning in adults; one had a false-negative scan despite the presence of ectopic gastric mucosa and the other had a false-positive scan, both confirmed by laparotomy. The available literature indicates that false-positive and false-negative scans occur relatively frequently in adults, but no comprehensive review on this subject exists. Based on our findings, it is suggested that Meckel's scanning be supplemented with small bowel infusion or arteriography or both to improve preoperative diagnosis in adult patients in whom a diverticulum is suspected.

Adult↗