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Revista Espanola de Enfermedades... Jan 2017As we know, the frequency of diverticular disease (DD) increases according to age, being less than 5% in patients under 40 years of age and up to 60% after 80 years of...
As we know, the frequency of diverticular disease (DD) increases according to age, being less than 5% in patients under 40 years of age and up to 60% after 80 years of age. The most common distribution of diverticula is in the left colon, except for the Asian population, where diverticular disease of the right colon is more frequent.
Topics: Colonic Diseases; Diverticulosis, Colonic; Diverticulum, Colon; Gastrointestinal Hemorrhage; Humans; Risk Factors
PubMed: 28044446
DOI: 10.17235/reed.2017.4821/2017 -
PloS One 2019Complications of diverticular disease are increasingly common, possibly linked to increasing obesity. Visceral fat could contribute to the development of symptomatic... (Observational Study)
Observational Study
BACKGROUND
Complications of diverticular disease are increasingly common, possibly linked to increasing obesity. Visceral fat could contribute to the development of symptomatic diverticular disease through its pro-inflammatory effects.
OBJECTIVE
The study had 2 aims. A) to develop a semi-automated algorithm to measure abdominal adipose tissue from 2-echo magnetic resonance imaging (MRI) data; B) to use this to determine if visceral fat was associated with bowel symptoms and inflammatory markers in patients with symptomatic and asymptomatic diverticular disease.
DESIGN
An observational study measuring visceral fat using MRI together with serum adiponectin, leptin, stool calprotectin and patient-reported somatisation and bowel habit.
SETTING
Medical and imaging research centres of a university hospital.
PARTICIPANTS
MRI scans were performed on 55 patients after an overnight fast measuring abdominal subcutaneous and visceral adipose tissue volumes together with small bowel water content (SBWC). Blood and stool samples were collected and patients kept a 2 week stool diary and completed a somatisation questionnaire.
MAIN OUTCOME MEASURES
Difference in the volume of visceral fat between symptomatic and asymptomatic patients.
RESULTS
There were no significant differences in visceral (p = 0.98) or subcutaneous adipose (p = 0.60) tissue between symptomatic and asymptomatic patients. However measured fat volumes were associated with serum adipokines. Adiponectin showed an inverse correlation with visceral adipose tissue (VAT) (Spearman ρ = -0.5, p = 0.0003), which correlated negatively with SBWC (ρ = -0.3, p = 0.05). Leptin correlated positively with subcutaneous adipose tissue (ρ = 0.8, p < 0.0001). Overweight patients (BMI > 25 kgm-2) showed a moderate correlation between calprotectin and VAT (ρ = 0.3, p = 0.05). Somatization scores were significantly higher in symptomatic patients (p < 0.0003).
CONCLUSIONS
Increasing visceral fat is associated with lower serum adiponectin and increased faecal calprotectin suggesting a pro-inflammatory effect which may predispose to the development of complications of diverticulosis.
Topics: Adiponectin; Adolescent; Adult; Aged; Aged, 80 and over; Body Mass Index; Diverticulum; Feces; Female; Humans; Insulin Resistance; Intra-Abdominal Fat; Leukocyte L1 Antigen Complex; Magnetic Resonance Imaging; Male; Middle Aged; Pilot Projects; Young Adult
PubMed: 31067253
DOI: 10.1371/journal.pone.0216528 -
Polski Przeglad Chirurgiczny Aug 2019Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract, with its incidence estimated at 1-4% in the general population. In most... (Review)
Review
Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract, with its incidence estimated at 1-4% in the general population. In most cases Meckel's diverticulum is a latent, asymptomatic anomaly, but in some cases, it may lead to complications such as intestinal obstruction, bleeding and inflammation. The literature provides no precise recommendations for the management of accidentally diagnosed, unaffected Meckel's diverticulum. The aim of this study was to review the literature on the subject to determine the current state of knowledge. Based on an analysis of 17 papers, the following criteria (risk factors) were identified justifying 'preventive' resection of an accidentally found, unaffected Meckel's diverticulum: age <50 years, male gender, length >2 cm, macroscopic abnormalities suggesting the presence of ectopic gastric mucosa as well as narrow neck of the diverticulum. When the criteria are not met, there is a minimal lifetime risk of complications. Leaving diverticulum intact is recommended in cases of peritonitis, major abdominal trauma and at older age. Nevertheless, indications or contraindications for resection are relative, and surgeons are safe to make their decision depending on individual patient's situation.
Topics: Gastrointestinal Hemorrhage; Humans; Intestinal Obstruction; Meckel Diverticulum; Risk Factors
PubMed: 31849359
DOI: 10.5604/01.3001.0013.3400 -
Scientific Reports Apr 2020Diverticulosis results from the development of pouch-like structures, called diverticula, over the colon. The etiology of the disease is poorly understood resulting in a...
Diverticulosis results from the development of pouch-like structures, called diverticula, over the colon. The etiology of the disease is poorly understood resulting in a lack of effective treatment approaches. It is well known that mechanical stress plays a major role in tissue remodeling, yet its role in diverticulosis has not been studied. Here, we used computational mechanics to investigate changes in stress distribution engendered over the colon tissue by the presence of a pouch-like structure. The objectives of the study were twofold: (1) observe how stress distribution changes around a single pouch and (2) evaluate how stress elevation correlates with the size of the pouch. Results showed that high stresses are concentrated around the neck of a pouch, and their values and propagation increase with the size of the pouch neck rather than the pouch surface area. These findings suggest that stress distribution may change in diverticulosis and a vicious cycle may occur where pouch size increases due to stress elevation, which in turn elevates stress further and so on. Significant luminal pressure reduction would be necessary to maintain stress at normal level according to our results and therapeutic approaches aimed directly at reducing stress should rather be sought after.
Topics: Biomechanical Phenomena; Colon; Computer Simulation; Diverticulosis, Colonic; Diverticulum, Colon; Female; Humans; Male; Models, Biological; Stress, Mechanical
PubMed: 32265489
DOI: 10.1038/s41598-020-63049-w -
Ultrasound in Obstetrics & Gynecology :... Jun 2023
Topics: Pregnancy; Female; Humans; Heart Defects, Congenital; Prenatal Diagnosis; Diverticulum; Heart Ventricles
PubMed: 36484455
DOI: 10.1002/uog.26137 -
The Pan African Medical Journal 2020Zenker's diverticulum is a rare and generally benign condition. Its occurrence in a hemodialysis patient has therapeutic and prognostic implications and is a risk factor...
Zenker's diverticulum is a rare and generally benign condition. Its occurrence in a hemodialysis patient has therapeutic and prognostic implications and is a risk factor for mortality and morbidity due to its complications, such as protein-energy malnutrition and pneumonitis. We here report a case of Zenker's diverticulum diagnosed in a chronic haemodialysis patient. The study involved a 61-year-old female patient admitted with upper gastrointestinal bleeding associated with dysphagia. Physical examination showed alteration of general condition and the patient reported an average weight loss of 5 kg in 3 months. Esophagogastroduodenal transit was characterized by dilatation of the cervical esophagus, appearing as a large heterogeneous niche whose upper pole was at the level of the pharyngoesophageal junction. The diagnosis of Zenker's diverticulum was retained. Diverticulectomy by cervical incision was performed. The patient died due to inhalational lung disease in the early postoperative period. Zenker diverticulum is a rare, generally benign disease, but in patients undergoing chronic haemodialysis, it increases mortality and morbidity.
Topics: Deglutition Disorders; Fatal Outcome; Female; Gastrointestinal Hemorrhage; Humans; Middle Aged; Renal Dialysis; Risk Factors; Zenker Diverticulum
PubMed: 33425154
DOI: 10.11604/pamj.2020.37.121.24932 -
Journal of Vascular Surgery May 2021The analysis of endovascular treatment of thoracic aortic diseases using new low-profile stent grafts in large series is crucial to understanding the durability of these...
OBJECTIVE
The analysis of endovascular treatment of thoracic aortic diseases using new low-profile stent grafts in large series is crucial to understanding the durability of these devices. The present study reports the midterm outcomes of a single-center experience using the Zenith Alpha thoracic endovascular stent graft.
METHODS
The outcomes of 270 procedures performed on 262 patients (197 men; mean age, 70.5 ± 9.5 years) using the Zenith Alpha thoracic endovascular stent graft from November 2013 to December 2019 for different thoracic aortic diseases were analyzed. The primary endpoints were 30-day clinical success and midterm (5-year) clinical success. The secondary endpoints were the adverse event rate at 30 days and midterm and access- and device-related complications. The follow-up of surviving patients was performed using computed tomography angiography and office visits at 1, 6, and 12 months and annually thereafter. Kaplan-Meier analysis was performed for overall survival, and freedom from thoracic aortic endovascular repair-related mortality and related reinterventions.
RESULTS
The overall 30-day mortality was 5.2% (2.5% for elective and 30.8% for nonelective cases). Type I endoleaks were identified in six patients. The 30-day primary technical and clinical success rates were 97.8% and 92.6%, respectively. Femoral cutdown was used in 41.1% of cases and percutaneous access in 58.5%. The rate of femoral artery complications after the percutaneous approach was 5.1%, with the need for surgical conversion in 1.9%. The stroke rate was 4.1% (major stroke, 2.2%), and the spinal cord ischemia rate was 3.7% (permanent paraplegia, 0.7%). Of the 248 survivors, 239 complied with the follow-up protocol with adequate computed tomography angiograms available images. Overall follow-up survival was 94.0% at 1 year, 91.6% at 2 years, 88.9% at 3 years, and 88.5% at 5 years. The unplanned secondary endovascular procedure rate was 5.3%. No stent fractures or new-onset type I endoleaks due to stent graft migration were observed in the study cohort.
CONCLUSIONS
The midterm outcomes of this new generation of low-profile devices were satisfactory. The reported low incidence of secondary procedures and the absence of migrations are promising for the long-term durability of these devices.
Topics: Aged; Aorta, Thoracic; Aortic Aneurysm, Thoracic; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Databases, Factual; Diverticulum; Endovascular Procedures; Humans; Italy; Male; Middle Aged; Postoperative Complications; Prosthesis Design; Reoperation; Retrospective Studies; Risk Factors; Stents; Time Factors; Treatment Outcome
PubMed: 33065242
DOI: 10.1016/j.jvs.2020.10.003 -
Journal of the Chinese Medical... Nov 2017Few studies have focused on the urodynamic findings of urethral diverticula (UD). We characterized the symptoms and urodynamic findings in women with UD.
BACKGROUND
Few studies have focused on the urodynamic findings of urethral diverticula (UD). We characterized the symptoms and urodynamic findings in women with UD.
METHODS
A retrospective review of all women in a single center having surgical treatment for symptomatic UD between May 2004 and September 2014 was done. Lower urinary tract symptoms were evaluated with International Prostate Symptom Score and Overactive Bladder Symptom Score questionnaires. All patients underwent magnetic resonance imaging and videourodynamic study (VUDS) prior to surgery, and postoperative evaluation with VUDS.
RESULTS
A total of 20 female patients were enrolled into the study. 12 (60%) UD patients presented with symptoms of stress urinary incontinence (SUI). However, there were merely 3 (15%) patients diagnosed as urodynamic SUI. 15 (75%) patients exhibited low catheter-free uroflow. Detrusor overactivity was demonstrated in 4 (20%) patients. Bladder outlet obstruction (BOO) was diagnosed in 8 (40%) cases. Postoperative VUDS revealed persistent BOO in 50% of patients with preoperative BOO. Of these, residual diverticulum was noted by VUDS in one patient.
CONCLUSION
For UD patients with urinary incontinence or voiding dysfunction, VUDS is helpful in accurately characterizing these symptoms.
Topics: Adult; Diverticulum; Female; Humans; Middle Aged; Retrospective Studies; Urethral Diseases; Urinary Bladder Neck Obstruction; Urodynamics
PubMed: 28807625
DOI: 10.1016/j.jcma.2017.07.003 -
Journal of Gastrointestinal and Liver... Dec 2018
Topics: Anti-Bacterial Agents; Diverticulosis, Colonic; Diverticulum, Colon; Humans; Rifaximin
PubMed: 30574613
DOI: 10.15403/jgld.2014.1121.274.rif -
Otology & Neurotology : Official... Oct 2022Internal auditory canal (IAC) diverticula, also known as IAC cavitary lesions or anterior cupping of the IAC, observed in otopathologic specimens and high-resolution...
INTRODUCTION
Internal auditory canal (IAC) diverticula, also known as IAC cavitary lesions or anterior cupping of the IAC, observed in otopathologic specimens and high-resolution computed tomography (CT) scans of the temporal bone are thought to be related to otosclerosis. Herein, we examined the usefulness of CT scans in identifying diverticula and determined whether IAC diverticula are associated with otosclerosis on otopathology.
METHODS
One hundred five consecutive specimens were identified from the National Temporal Bone Hearing and Balance Pathology Resource Registry. Inclusion criteria included the availability of histologic slides and postmortem specimen CT scans. Exclusion criteria included cases with severe postmortem changes or lesions causing bony destruction of the IAC.
RESULTS
Ninety-seven specimens met criteria for study. Of these, 42% of the specimens were from male patients, and the average age of death was 77 years (SD = 18 yr). IAC diverticula were found in 48 specimens, of which 46% were identified in the CT scans. The mean area of the IAC diverticula was 0.34 mm 2 . The sensitivity and specificity of detecting IAC diverticula based on CT were 77% and 63%, respectively. Overall, 27% of specimens had otosclerosis. Histologic IAC diverticula were more common in specimens with otosclerosis than those without (37.5% versus 16%; p = 0.019). Cases with otosclerosis had a greater mean histologic diverticula area compared with nonotosclerosis cases (0.69 mm 2 versus 0.14 mm 2 ; p = 0.001).
CONCLUSION
IAC diverticula are commonly found in otopathologic specimens with varied etiologies, but larger diverticula are more likely to be associated with otosclerosis. The sensitivity and specificity of CT scans to detect IAC diverticula are limited.
Topics: Aged; Diverticulum; Ear, Inner; Humans; Male; Otosclerosis; Petrous Bone; Temporal Bone; Tomography, X-Ray Computed
PubMed: 36075107
DOI: 10.1097/MAO.0000000000003665