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PubMedDate not supplied

[Surgical treatment of colonic diverticulosis: results of a series of 70 cases].

Results are reported on a series of 70 patients operated upon for colon diverticulosis, surgery being elective in only 23 (32.9%) cases. Global mortality (12.9%), was higher in patients over 70 years of age (P < 0.01) and for emergency cases (17% against 4.3% (NS) after cold surgery). Global morbidity was 20%, the onset of septic complications being influenced (p < 0.01) only by treatment with antiinflammatory drugs. Despite the absence of precise factors predictive of the course of diverticular disease, it should be possible to further improve the very poor prognosis in patients with serious septic complications (Hinchley's stages I to IV) by: prophylactic colectomy in symptomatic diverticulosis, improved evaluation by complementary examinations, notably the scanner, of localized septic complications (stages I and II), with the possible association of guided puncture to avoid the septic areas and to allow performance of a cold colectomy without the need for colostomy. Certain severe septic complications may still develop and these cannot be totally prevented by any therapy. In these cases preference is given to resection of the septic focus using mainly Hartmann's operative techniques. Further studies are needed to evaluate those cases where protected anastomotic resection provides the best results, since in the long term the incidence of re-establishment is higher.

Abscess↗
PubMed2004

Consider colonoscopy for young patients with hematochezia.

BACKGROUND: Hematochezia is a common complaint in adult patients aged <50 years. Most studies of lower endoscopy for rectal bleeding have concentrated on older patients or have failed to mention the location of lesions. OBJECTIVE: To determine the findings of complete colonoscopy in adults younger than 50 years with rectal bleeding. METHODS: Data were retrieved from medical records and included demographics, indications, endoscopic findings, and histology. Lesions were labeled according to location: proximal to the splenic flexure or distal to (and including) the splenic flexure. Excluded were those with a history of colitis, colorectal cancer, polyps, anemia, significant weight loss, severe bleeding, or strong family history of colorectal cancer. RESULTS: The study included 223 patients with rectal bleeding aged <50 years who had undergone a colonoscopy. Normal findings were recorded for 48 (21.5%). Four (1.8%) were diagnosed with cancer in the distal colon, and 22 (9.9%) were found to have colon adenomas, 6 of whom had proximal adenomas only. Hemorrhoids were present in 135 patients (60.5%). Other findings included colitis, angiodysplasia, diverticulosis, anal fissures, and rectal ulcers. CONCLUSIONS: Colon neoplasms may be present even in younger adults with nonurgent rectal bleeding. Though most findings were benign and located in the distal colon, colonoscopy should be strongly considered for this patient group.

Adenoma↗
PubMedDate not supplied

[Anatomical and clinical features of a case of gall-bladder abnormality. Results of arteriographic and micro-angiographic studies (author's transl)].

The authors describe a perplexing clinical picture in which an important factor for diagnosing the lesion in the gall-bladder was hyperselective arteriography of the coeliac trunk, and more especially the hepatic artery. The association of a truc septum in the gall-bladder, without gall-stones, and of another digestive tube lesion, megadolicho-sigmoid and diverticulosis of the sigmoid, would appear to be an extremely rare entity, and this has been the cause of the pain reported by the patient over many years. The cholecystectomy performed appears to be the right choice, and the most effective therapeutic procedure.

Angiography↗
PubMed1990

[Motility of the sigmoid in irritable bowel syndrome and colonic diverticulosis].

The results of pressure recording in patients with irritable bowel syndrome, diverticulosis and diverticulosis with pain were compared with the results in control subjects. The motility showed variable higher values in patients with irritable bowel syndrome. The motility was clearly higher in patients with diverticulosis and in patients with diverticulosis with pain. The patients with irritable bowel syndrome were younger than the patients in the two groups with diverticulosis. These findings are consistent with the hypothesis that the irritable bowel syndrome is an aetiologic factor in diverticulosis.

Adult↗
PubMed1987

[Surgical tactics in diverticulosis of the sigmoid].

The article presents an experience with the surgical treatment of 27 patients with diverticulosis of the sigmoid colon. It was established that the indications and operation volume should be individualized in correlation with the complication of diverticulosis. In weak patients with critical concomitant diseases good results were obtained after operation of exclusion of the left half of the colon. A modification of the Hartman operation is proposed which reduces the danger of incompetence of the rectum stump sutures and makes the time of treatment shorter.

Adult↗
PubMed1986

Irritable bowel syndrome and symptomatic diverticular disease--different diseases?

The influence of colonic diverticula on symptomatology and prognosis was investigated in 69 patients with irritable bowel syndrome. Roentgenograms at the time of diagnosis were blindly correlated to patient complaints and to result of follow-up 5 to 7 yr after the irritable bowel syndrome had been diagnosed. Patient complaints were not related to the presence or extent of diverticulosis. Half the patients had unchanged or aggravated symptoms at follow-up irrespective of diverticulosis. Accordingly, the presence of colonic diverticula did not change the natural history of the irritable bowel syndrome.

Adult↗