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At least 127 records · Page 7Linked to original sources
PubMed1990

Surgical significance of acquired ileal diverticulosis.

Acquired (non-Meckel's) ileal diverticular disease is uncommon, and most surgeons have limited, if any, experience with this condition. To gain insight into the frequency of surgical complications of ileal diverticula, we reviewed our experience during the past ten years with 21 patients, 12 women, and nine men. The mean patient age was 62 years; 16 patients (76%) were more than 50 years of age. Thirteen patients had associated diverticula in another segment of the small intestine. In 15 patients ileal diverticulosis was diagnosed during gastrointestinal (GI) radiologic evaluation of abdominal symptomatology. Ileal diverticula were identified intraoperatively in the remaining six patients. In three patients ileal diverticulosis was an incidental finding. Documented surgical complications of acquired ileal diverticula occurred in four patients (19%). Three patients had acute diverticular perforation, and one patient had diverticulitis without perforation. These patients underwent successful operative intervention. Three other patients, all managed nonoperatively, had abdominal symptoms that may have been related to ileal diverticula and were of potential surgical significance. Two patients experienced recurrent rectal bleeding, and the third patient had severe chronic abdominal pain. Although the majority of patients with acquired ileal diverticula do not require surgical treatment, complications such as perforation, bleeding, or incapacitating abdominal pain may necessitate ileal resection.

Adult↗
PubMed1990

[Leiomyosarcoma of the Meckel's diverticulum and multiple diverticulosis of the ileum. Apropos of a case].

We report a case of a leiomyosarcoma arising in a Meckel's diverticulum in a man of 90 years, with multiple ileal diverticulosis. The clinical picture was similar to acute appendicitis and diagnosis was not made until resection of an abdominal mass with histological appearance of leiomyosarcoma. 59 cases of leiomyosarcoma of Meckel's diverticulum have previously been reported in the literature. No case until now has been reported in a patient of Caribbean origin neither in association with ileal diverticulosis. Although rare, leiomyosarcoma is the commonest sarcoma of Meckel's diverticulum, and with full resection of the tumor the prognosis is very good.

Aged↗
PubMed1987

[Diverticulosis of the jejunum and ileum].

Six cases of diverticulosis of the small intestine are reported in this paper. Described in some detail is the pathological pattern of diverticula in jejunum and ileum. There are chronic courses with recurrent complaints in the epigastric region and with malabsorption syndrome which may lead to megaloblastic anaemia, steatorrhoea, and dermatosis. Acute processes are caused by perforation, diverticulitis, and haemorrhage. Ileus can develop owing to strangulation or, in less frequent cases, owing to incarceration of enteroliths. Chronic pneumoperitoneum may be attributable to massive jejunal diverticulosis.

Aged↗
PubMed1978

Pathogenesis of bleeding colonic diverticulosis: new concepts.

Diverticulosis of the colon is a common disease of the older population which develops in those people who eat highly refined carbohydrate diets free of roughage. High intraluminal pressures are created in the resultant narrowed colon which tends to push the mucosa between circular muscle bundles through oblique connective tissue clefts containing the vasa recta. Massive bleeding of the colon is most commonly due to right-sided diverticulosis. It can be explained by chronic injury to the vasa recta which lie within the submucosa of the diverticulum from the apex to the antimesenteric orifice. Rupture has been documented to occur when the wall of the artery facing the diverticulum becomes weakened by intimal fibrosis, elastic lamina fragmentation, and smooth muscle atrophy. This occurs at the dome and at the antimesenteric orifice of the diverticulum. Selective angiography is the diagnostic tool of choice. Recent advances in pharmacoagiography and and embolization promise successful treatment with lower morbidity than surgical resection.

Adult↗
PubMedDate not supplied

[Diverticulosis of the appendix].

Diverticulosis of the appendix. Diverticulosis of the appendix is a rare condition. Cause of the danger of perforation, it is not an unimportant entity. We present six examples and review its pathogenesis, diagnosis and treatment.

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↗
PubMedDate not supplied

[Diverticulosis-diverticulitis].

Diverticulosis of the colon and its clinical sequelae--diverticulitis, peridiverticulitis, and pericolitis--are typical diseases of elderly people. The main causes are weakness of the connective tissue in the colonic wall increasing with age and pathologic motility pattern of the colon due to low dietary fibre consumption. In about 20% of all people with diverticula, acute or chronic-recurrent diverticulitis develops, often with serious complications as perforation, abscess or fistula formation, obstruction, inflammatory pseudotumor and intestinal bleeding. Diagnosis is mainly based on clinical examination and barium enema (double contrast, maximal spasmolysis). Colonoscopy may be helpful in excluding carcinoma of the large bowel. Patients with diverticulosis and uncomplicated diverticulitis should be managed conservatively by medical treatment. The following measures proved to be successful: high-fibre diet, unprocessed wheat bran, and hydrophilic plant colloids to regulate the bowel movements, systemic or local antibiotics if signs of inflammation are present, and antispasmodics or analgesics against abdominal pain. Prognosis depends mainly on the duration of the disease, sufficient dietary-fibre intake, and elective or semi-elective surgical intervention before the development of life-threatening complications. The question as to whether diverticula or relapsing attacks of diverticulitis can be prevented with added dietary-fibre remains open for the time being.

Abscess↗
PubMed1983

[Complications of colonic diverticulosis and their treatment].

Diverticulosis coli is one of the commonest diseases of the colon. Its importance arises from complications. In the period of 1974-1981 a total of 661 cases of diverticulosis coli were treated at this clinic. In 75% of cases the diverticula were localized in the left colon. Differential diagnosis must aim to exclude the presence of other diseases, especially malignancies of the rectum and sigmoid colon. 165 patients (25%) underwent surgery. In elective surgery lethality was only 2,9%. The poor prognosis when complications have occurred supports the author's view, that operation should be done early in patients with chronic recurrent diverticulitis.

Adult↗
PubMed1980

[Treatment of complicated diverticulosis of the sigmoid colon (author's transl)].

55 patients suffering from diverticulosis of the sigmoid colon underwent surgery, 32 of them in a state of emergency (peritonitis, ileus); mortality rate 22%. In 28 patients a colostomy was performed, which later on could be removed to restore the continuity of the colon. The therapy of choice in the early stage of diverticulosis is resection of the sigmoid colon performed as a ono-stage procedure (mortality rate les than 1%).

Adult↗
PubMedDate not supplied

[Radiologic diagnosis of inflammatory complications of colonic diverticulosis].

The authors analyze x-ray findings in 194 patients with colonic diverticulosis and its inflammatory complications. Clinical, x-ray, and morphologic studies helped the authors to specify the x-ray semeiotics of diverticulitis, paraintestinal infiltrates, intestinal fistulas. An optimal complex of radiological methods to detect each of these complications has been developed. The authors claim that irrigoscopy supplemented, if necessary, with simultaneous fistulography, or oral enterography is the priority and basic method for the diagnosis of inflammatory complications of colonic diverticulosis.

Adult↗
PubMed1995

Colovesical fistula complicating colonic diverticulosis.

Two cases of colovesical fistulae secondary to colonic diverticulosis are reported. Urinary symptoms were the prominent presenting features. Barium enema was helpful in documenting the fistulae, which cystoscopically was not localised. Definitive treatment included resection of the fistula and the diseased segment of the intestine. Both patients are well on follow-up. Diverticulosis coli should be considered in the differential diagnosis of colovesical fistulae even in tropical countries.

Aged↗
PubMed1993

[Diverticulosis].

Diverticula of the colon are very common in developed countries. In most of those affected diverticulosis is an asymptomatic condition. Only 20% complain of recurrent symptoms. Symptomatic diverticulosis is common only after the age of 50. Dietary treatment combined with antispasmodics is generally sufficient. Diverticular disease is complicated by bleeding or by diverticulitis in 20% of symptomatic patients. Diverticulitis itself can be complicated by intra-abdominal abscess, fistulas, perforation with generalized peritonitis or bowel obstruction. Each clinical appearance is described and treatment is discussed.

Abscess↗
PubMed1995

[Diverticulosis of the small intestine].

Small bowel diverticulosis is a rare disease of gastrointestinal tract that occurs most frequently in older patients. Since this disease can be asymptomatic, for a long time, the diagnosis rarely is made in the preoperative period. In 40% of cases there are acute or chronic complications, most frequently diverticulitis either with or without perforation, bowel obstruction and massive haemorrhage clinically manifested as bleeding from the lower part of the gastrointestinal tract. Abdominal pain, pseudoobstructive and malabsorption syndrome, expressive weight loss, steatorrhea and anemia are common chronic complications. In these cases a surgical treatment is necessary. Resection of the affected part of the small bowel is usually performed with end-to-end anastomosis. The authors present 4 cases with diverticulosis of the small bowel, two cases of which were manifested by diverticulitis and one of them was perforated. Pseudoobstructive syndrome, malabsorption and expressive weight loss were presented in other two cases. All four cases were dominated by severe abdominal pain. The surgical treatment was based upon radical resection of the small bowel with end-to-end anastomosis. (Fig. 4, Ref. 28.)

Adolescent↗
PubMedDate not supplied

Small bowel diverticulosis. A forgotten diagnosis.

Small bowel diverticulosis (SBD) have the lowest incidence of diverticulosis of the alimentary tract. The incidence differs from 0.09% to 2.3% depending on the reporting physician. SBD are pseudodiverticula, consisting of mucosa only. The causes of SBD are not clear, but the "locus minoris resistentiae" theory is most widely accepted. Overactive or irregular peristalsis bulges the mucosa out through vascular defects in the bowel wall. Only meticulous radiographic techniques can lead to a diagnosis. Preoperative diagnosis is exceptional. SBD can produce chronic abdominal discomfort. Acute complications are also numerously described, giving rise to a surgical emergency. Resection of the involved segment is then the only good procedure. Two cases presenting major complications are discussed, followed by a review of the literature.

Aged↗
PubMed1996

Case report: gastrointestinal haemorrhage from jejunal diverticulosis, probably induced by low dose aspirin.

A 66-year-old female, who had been taking low dose aspirin for approximately 6 months, was admitted to hospital with severe gastrointestinal bleeding. The source of bleeding could not be demonstrated despite gastroscopy, mesenteric angiography and 99mTc-labelled red blood cell scanning. Mesenteric angiography was repeated, demonstrating a site of bleeding in the proximal small intestine. Laparotomy revealed blood-filled jejunal diverticulosis. Resection of the affected segment resulted in cessation of haemorrhage and the patient remains well in follow up. The present report illustrates a rare cause of gastrointestinal haemorrhage, the possible role of aspirin in causation and the difficulty in diagnosis of bleeding from jejunal diverticulosis.

Aged↗
PubMed1997

Small-bowel diverticulosis: perceptions and reality.

BACKGROUND: Small-bowel diverticulosis is a rare entity that can be discovered incidentally during celiotomy, endoscopy, or radiographic imaging studies. The reported complication rate is low, giving rise to the current recommendation not to treat uncomplicated small-bowel diverticula. STUDY DESIGN: A retrospective review was performed of patients with small-bowel diverticulosis seen during 23 years at three major institutions. RESULTS: Two hundred eight patients were identified. Diverticula were located in the duodenum in 79 percent; in the jejunum or ileum in 18 percent; and in duodenum, jejunum, and ileum in 3 percent. Complications developed in 42 of the 208 patients (20 percent) including bleeding in 14, diverticulitis with perforation and abscess formation in 12, and malabsorption in 8. When assessed by location, jejunoileal diverticula were more likely to have complications than duodenal diverticula: 46 percent compared to 13 percent (p < .01). Bleeding accounted for 52 percent of the duodenal complications compared to 12 percent of the jejunoileal complications (p < 05). Jejunoileal diverticula were more likely to perforate and develop abscesses (21 percent compared to 1.2 percent; p < .001). CONCLUSIONS: The low incidence of complications associated with duodenal diverticula justifies a nonoperative approach. The higher complication rate associated with jejunoileal diverticula will be necessary to define that approach more exactly.

Adult↗