Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Sigmoid Diseases”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1999

Appendicular involvement in perforated sigmoid disease: US and CT findings.

We describe four patients in whom ultrasound (US) and/or computed tomography (CT) demonstrated a thickened appendix, secondarily enlarged due to perforated sigmoid diverticulitis (n = 2) or carcinoma (n = 2). The underlying pathology was correctly recognized in all cases. Secondary thickening of the appendix due to perforated sigmoid disease provides a potential pitfall mainly on US and may lead to an incorrect diagnosis and thus to unnecessary surgery or a wrong surgical intervention. Although US alone is enough to diagnose periappendicitis and sigmoid disease, combined use of US and CT may improve assessment of its origin and extension.

Adenocarcinoma↗
PubMed1984

The septic complications of sigmoid diverticular disease.

In 2 years 41 patients were treated surgically for septic complications of diverticular disease of the sigmoid colon. Nine patients had fistulae arising from sigmoid diverticular disease. Resection of the sigmoid was undertaken as the primary procedure in 8 patients with anastomosis in 5. Thirty-two patients had pericolic abscesses or peritonitis. The outcome (morbidity, length of stay) of the 21 patients who underwent primary resection was compared with that of the 11 patients treated by defunctioning colostomy alone. The better results in the larger group of 21 patients indicate that primary resection should be the treatment of choice for the septic complications of diverticular disease.

Abscess↗
PubMedDate not supplied

[Sigmoid diverticular diseases: surgical treatment].

From 1966 to 1990, 226 consecutive patients were operated on electively for diverticular disease of the sigmoid colon. The indications for surgery were colovesical fistula or suspicion of residual abscess, existence of two or more previous attacks of acute inflammation, existence of chronic symptoms and suspicion of colonic carcinoma. Colonic resection with primary anastomosis was performed in 217 patients with a covering colostomy in 1 case only. The Hartmann procedure was performed in 9 patients with extension of the lesions to the rectum and/or high operative risk. One or more abscesses were found by the surgeon or the pathologist in 50 p. cent of the patients. There were no postoperative deaths, no clinical anastomotic leakages. Long-term results were evaluated for the patients operated on before 1987, with a follow-up from 2 to 22 years. 85 p. cent of the patients had no more symptoms, 11 p. cent complained of persistent symptoms and 3% had recurrent attacks of pain and fever. Colonic barium enema is the best examination for diverticulitis and chronic abscesses. Surgical treatment is easier for abscesses located within the colonic wall and mesentery, than for extracolic abscesses with local peritonitis. Correlations between preoperative symptoms and operative findings are often not good. The good results obtained in 82 p. cent of the patients operated on for chronic symptoms suggest that chronic symptoms should be part of the indications for elective surgery. The low incidence (3 p. cent) of recurrent attacks of pain and fever is in favour of a resection limited to the sigmoid colon even when diffuse colonic diverticula are present.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Diverticula, neoplasia, or both? Early detection of carcinoma in sigmoid diverticular disease.

In 105 patients with symptomatic sigmoid diverticular disease, colonoscopy revealed an associated frequency of carcinoma of seven (6.6%) (Dukes A in 4, B in 2, and C in 1) and adenomas in 29 (27.6%), with a peak incidence of 60 to 79 years and an equal sex distribution. In 45 (43%) examinations, the barium enema was inaccurate. The presenting complaints of abdominal pain and/or alteration in bowel habit in 36 patients with neoplasms and 69 without were similar, but significantly more patients with neoplasms complained of rectal bleeding (p less than 0.05). Endoscopic examination is therefore recommended in patients with sigmoid diverticular disease, particularly in those aged over 60 years and with rectal bleeding.

Aged↗
PubMed2005

[Indications and long term results of elective surgery for sigmoid diverticular disease].

BACKGROUND: There are no clear guidelines for the indication of elective surgery in sigmoid diverticular disease. AIM: To analyze the indications and long term results of elective surgery in sigmoid diverticular disease. MATERIAL AND METHODS: Retrospective review of 100 patients (age range 25-86 years, 51 male) with sigmoid diverticular disease, operated in a lapse of 22 years. Sixty seven patients answered a survey about their disease at the end of follow up. RESULTS: Among patients aged more than 70 years, there was a higher proportion of women. The main indication for surgery was recurrent diverticulitis in 54 patients, followed by diverticular fistula in 19. A sigmoidectomy was performed in 91 patients. Stapled anastomosis was performed in half of these patients. No patient died or required reoperation in the immediate postoperative period. During a follow up ranging from 8 to 280 months, 28 patients died for causes not associated with diverticular disease and five were lost. Those patients that answered the survey were free of symptoms related to diverticular disease and did not require new operations. CONCLUSIONS: In patients with sigmoid diverticular disease and recurrent diverticulitis or with fistulae, the long term results of surgery are satisfactory.

Adult↗
PubMed2003

Population-based incidence of complicated diverticular disease of the sigmoid colon based on gender and age.

PURPOSE: The purpose of this study was to characterize the gender and age differences in patients with clinically symptomatic sigmoid diverticular disease requiring surgery. METHODS: All surgical patients hospitalized with proven diverticular disease requiring sigmoid resection from January 1988 to January 1998 were reviewed. RESULTS: A total of 934 patients requiring surgical resection for diverticular disease were admitted. There were 443 men and 491 women with an average age of 64. Forty-nine patients presented with massive rectal bleeding (males, 3.6 percent; females, 1.6 percent), 329 with chronic diverticulitis (males, 15.8 percent; females, 19.3 percent), 61 with obstructive symptoms (males, 2.7 percent; females, 3.9 percent), 148 with fistulas (males, 8.0 percent; females, 7.8 percent), 170 with perforation (male, 8.7 percent; female, 9.4 percent), 79 with abscess (males, 4.0 percent; females, 4.5 percent), 59 with stricture (males, 2.2 percent; females, 4.0 percent), and 39 with acute diverticulitis (males, 2.2 percent; females, 1.9 percent). Overall, patients younger than 50 presented more often with chronic or recurrent diverticulitis. CONCLUSIONS: Female patients present, on average, five years later than male with complications requiring surgery. Overall, men have a higher incidence of bleeding (P = 0.015), whereas women present more often with stricture and obstruction (P = 0.02). Young males present more with fistula (P = 0.03), whereas older males present with bleeding (P = 0.001). Young females present with perforation (P = 0.002), and older females present with chronic diverticulitis (P = 0.04) and stricture (P = 0.04).

Age Factors↗
PubMed2002

Laparoscopic colectomy vs. open colectomy for sigmoid diverticular disease.

PURPOSE: The feasibility of laparoscopic colectomy for colon surgery has now been well established. Most of the studies on laparoscopic colectomies include all types of colonic pathologies without discrimination. Our goal was to compare laparoscopic sigmoid colectomy open sigmoid colectomy for simple sigmoid diverticular disease, to assess whether it can be done safely and whether the proposed advantages could be realized. METHODS: We evaluated the differences in outcomes of 66 laparoscopic sigmoid colectomy patients and 88 open sigmoid colectomy patients. We report a five-year outcomes analysis of 154 patients undergoing sigmoid colectomy for diverticular disease. We compared age, gender, history of prior abdominal surgery, estimated blood loss, operative time, total conversions with reason for conversion, time until a liquid diet was started, postoperative complications, hospital length of stay, operation costs, and total hospital charges incurred for both laparoscopic sigmoid colectomy and open sigmoid colectomy. RESULTS: Mean age and gender were similar in the two groups. However, the mean estimated blood loss (143 ml 314 ml), time until a liquid diet was started (2.9 4.9 days), and hospital length of stay (4.8 8.8 days) were all significantly less in laparoscopic sigmoid colectomy patients. The mean operative time for laparoscopic sigmoid colectomy was 212 minutes as compared with 143 minutes for open sigmoid colectomy ( < 0.05). Conversion rate of laparoscopic sigmoid colectomy to open procedure was 19.7 percent. All laparoscopic sigmoid colectomy patients received a lighted ureteral stent preoperatively, which was removed at the end of surgery. Relevant complications for laparoscopic sigmoid colectomy open sigmoid colectomy were as follows: anastomotic leak in 1 3 (1.5 3.4 percent) patients, hematuria in 64 6 (97 6.8 percent) patients, with an average duration for 2.93 3 days, urinary tract infection in 5 4 (7.6 4.5 percent) patients, and ureteral injury in 1 2 (1.5 2.2 percent) patients. Although the mean operating room charges were greater in the laparoscopic sigmoid colectomy patients ($9,566 $7,306) the mean hospital charges ($13,953 $14,863) were less. CONCLUSIONS: We recommend laparoscopic sigmoid colectomy as the modality of treatment for diverticular disease. Laparoscopic sigmoid colectomy seems to be a reliable, safe and efficacious treatment modality with better outcomes for diverticular disease of the sigmoid colon. The operative time for laparoscopic sigmoid colectomy is decreasing as surgeons gain more experience.

Colectomy↗
PubMed1989

Coexistent Crohn's disease and sigmoid diverticulosis.

This study reports six patients with a diagnosis of diverticular disease with associated localized Crohn's colitis who were all treated by segmental resection. Two patients died in the post-operative period from disease unrelated to their colonic pathology. The remaining four patients remain well, show no signs of recurrent disease and have required no further surgery. The behaviour and significance of the two conditions occurring in the same patient is discussed.

Aged↗
PubMedDate not supplied

CT colonography features of sigmoid diverticular disease.

OBJECTIVE: The objective of this study is to assess the sigmoid distensibility during CT colonography (CTC) in patients with diverticular disease. METHODS: Consecutive patients without a history of pelvic radiation or neoplasms underwent 150 CTC. Three radiologists in consensus evaluated axial images for colonic distention, luminal diameters (mm), diverticula, and muscular thickening. RESULTS: The minimum colon diameter in patients with muscular thickening was significantly smaller, irrespective of the presence of diverticula (P=.009). CONCLUSION: Muscular thickening with diverticular disease was associated with significantly less sigmoid colon distension.

Adult↗
PubMed2005

French multicentre prospective observational study of laparoscopic versus open colectomy for sigmoid diverticular disease.

BACKGROUND: The aim of this study was to compare in-hospital morbidity and mortality rates after elective laparoscopic and open colorectal surgery for sigmoid diverticular disease (SDD). METHODS: This prospective national multicentre observational study included all consecutive patients undergoing open or laparoscopic elective colectomy for SDD in a 4-month period between June and September 2002. Postoperative in-hospital mortality and morbidity in the two groups were compared. RESULTS: Three hundred and thirty-two consecutive patients undergoing either laparoscopic (163 patients) or open (169 patients) colectomy for SDD were analysed. Overall postoperative mortality and morbidity rates were 0.3 and 23.8 per cent respectively. The morbidity rate was significantly higher in the open than in the laparoscopic group (P < 0.001), leading to a significantly longer hospital stay (P < 0.001). The morbidity rate remained significantly higher in the open group when the patients were matched for age (P = 0.015) or American Society of Anesthesiologists score (P = 0.028). An open procedure (relative risk (RR) 2.13 (95 per cent confidence interval (c.i.) 1.29 to 3.45)), age over 70 years (RR 1.62 (95 per cent c.i. 1.14 to 2.30)) and intraperitoneal contamination (RR 2.54 (95 per cent c.i. 1.18 to 5.50)) were identified as independent risk factors for morbidity. CONCLUSION: A laparoscopic approach to elective treatment of SDD may be associated with reduced postoperative morbidity and hospital stay. A randomized study is required to confirm these results.

Aged↗
PubMed2006

Benign mesothelioma of the appendix: an incidental finding in a case of sigmoid diverticular disease.

Benign multicystic mesothelioma is a well recognised but rare entity. The aim of this report is to describe a case of a small mesothelial proliferation of the peritoneum. A 58 year old postmenopausal woman presented with left sided abdominal pain and altered bowel habit. Radiological investigations (barium enema and computed tomography scan of the abdomen and pelvis) were undertaken. An operation was performed for symptomatic sigmoid diverticular disease. Unusually, the appendix was adherent to the sigmoid colon. Microscopy revealed a benign mesothelioma. The patient remains symptom free to date.

Appendiceal Neoplasms↗
PubMed2001

Short-term functional outcome following elective surgery for complicated sigmoid diverticular disease: sutured or stapled end-to-end anastomosis to the proximal rectum?

OBJECTIVE: The aim of this retrospective non-randomized study was to evaluate the short-term functional outcome following elective resectional surgery for complicated sigmoid diverticular disease, and to compare results of patients having hand-sewn or stapled end-to-end colonic anastomosis to the proximal rectum. PATIENTS AND METHODS: Between 1983 and 1995, of 182 consecutive patients referred to our Institution for surgical treatment of complicated sigmoid diverticular disease, 137 underwent elective left hemicolectomy with primary colonic anastomosis to the proximal rectum, at a level above the peritoneal reflection. Twenty-one patients were excluded from the study because of a covering stoma (n=15), or a side-to-end (n=5) or side-to-side (n=1) anastomosis. All remaining 116 patients had an end-to-end anastomosis without covering stoma. Two groups were compared according to the type of anastomosis performed. Group I comprised the 67 patients who had a hand-sewn anastomosis, and group II the 49 patients whose anastomosis was stapled. Outcome was assessed at 6 months after surgery and compared in the two groups. Assessment included specific morbidity (anastomotic leakage, haemorrhage, fistulation and stenosis, pelvic sepsis), faecal incontinence, constipation, dyschesia, daily stool frequency, and stool consistency. RESULTS: Preoperative patient details were comparable in both groups. There was no post-operative mortality, and the general morbidity rate was similar in both groups (P=0.85). There was no anastomotic leakage or haemorrhage, and no fistulation or pelvic sepsis in either group. One patient in group I, and two from group II, developed flatus incontinence, and a further patient from group II developed incontinence to liquid stool (P=0.17, group I vs group II). We observed better functional outcome following hand-sewn anastomosis. Three group II patients developed anastomotic stenosis compared with none in group I (P=0.04). Constipation (9% vs 28%, P=0.005) and dyschesia (18% vs 39%, P=0.03) were more frequent in group II. Excluding constipated patients (n=20), daily stool frequency was lower (mean 1.2 +/- 0.6 vs 2 +/- 1.3, P=0.0002), and more frequently of normal consistency (79% vs 43%, P=0.0001) in group I. Subgroup analysis failed to show significant differences in functional outcome in both groups in relation to the specific indications for surgery. CONCLUSION: These retrospective data suggest for the first time in the reported literature that hand-sewn colonic anastomosis to the proximal rectum provides a better short-term functional outcome than stapled anastomosis following elective resectional surgery for complicated sigmoid diverticulosis.

Journal Article↗
PubMed1998

Prevalence of diverticulosis and incidence of bowel perforation after kidney transplantation in patients with polycystic kidney disease.

Sigmoid perforation due to diverticulitis is a life-threatening complication in the postoperative course of allogenic kidney transplantation. The incidence of diverticulosis is especially high among patients with autosomal dominant polycystic kidney disease (ADPKD). Thus, those who undergo allogenic kidney transplantation represent a high-risk group. The aim of this study was to evaluate the prevalence of diverticulosis in ADPKD patients awaiting renal transplantation and the incidence of bowel perforation following allogenic kidney transplantation due to ADPKD. Within the group of 1128 patients who underwent transplantation between January 1974 and January 1990, there were 46 patients (4.07%) whose indication for transplantation was ADPKD. There was one patient who developed a sigmoid perforation under postoperative immunosuppression. Surgical treatment was a discontinuity resection of the sigmoid (Hartmann's procedure). The postoperative course was favorable, the bowel continuity has already been restored, and the graft is still functioning well. Fifteen of the 28 (53.5%) ADPKD patients awaiting transplantation had colon diverticulosis (12 male and 3 female patients). No case of bowel perforation has thus far been observed in 15 of these patients who have undergone transplantation. A sigmoid resection was necessary in one patient due to diverticulitis without perforation. We did not find a higher prevalence of diverticulosis in patients with ADPKD, nor did we see a higher incidence of sigmoid perforation during post-transplant immunosuppression in this study.

Adult↗