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BMJ Case Reports Feb 2019
Topics: Aged; Hernia, Femoral; Humans; Male; Meckel Diverticulum
PubMed: 30824469
DOI: 10.1136/bcr-2018-228784 -
Ugeskrift For Laeger Apr 2024Meckel's diverticulum is the most common congenital gastrointestinal defect with a prevalence of 2%. It is mostly asymptomatic and it rarely causes acute abdomen in...
Meckel's diverticulum is the most common congenital gastrointestinal defect with a prevalence of 2%. It is mostly asymptomatic and it rarely causes acute abdomen in adults. In this case report, a 28-year-old male with no previous abdominal surgery presented with clinical symptoms of small bowel obstruction. Surgery revealed a Meckel's diverticulum adherent to the abdominal wall, causing internal herniation with small bowel obstruction. The diverticulum was openly resected and no post-operative complications occurred. Laparoscopy seems safe, and surgical removal of the symptomatic Meckel's diverticulum is recommended.
Topics: Humans; Meckel Diverticulum; Adult; Male; Ileus; Tomography, X-Ray Computed; Intestinal Obstruction
PubMed: 38704710
DOI: 10.61409/V10230632 -
International Journal of Colorectal... Sep 2023There is a hypothesis of an association between diverticulosis and metabolic syndrome (MS) or its components, but data on this topic are inconsistent, and a systematic... (Review)
Review
BACKGROUND
There is a hypothesis of an association between diverticulosis and metabolic syndrome (MS) or its components, but data on this topic are inconsistent, and a systematic review has not been performed. We conducted a systematic review to investigate the possible association between cardiometabolic risk factors and diverticulosis.
METHODS
A systematic literature search was conducted via PubMed, Cochrane Library, and Web of Science in December 2022 to collect the necessary data. Studies that examined the association between MS or individual metabolic factors and asymptomatic diverticulosis were included in the review.
RESULTS
Of the potentially relevant articles identified via PubMed (477), Cochrane Library (224), and Web of Science (296), 29 articles met the inclusion criteria and were used for this work. These studies were assessed for study quality using GRADE. Overall, 6 studies were rated as "very low," 19 studies as "low," and 4 studies as "moderate." The data suggest an association between arterial hypertension, obesity, and fatty liver disease in younger patients and diverticulosis. Patient age appears to play an important role in diverticular formation. Data on diabetes mellitus is inconclusive and may require further investigation depending on the location of the diverticula.
CONCLUSION
Based on the synthesized data, there is an association between arterial hypertension, obesity, and fatty liver disease in younger patients. The formation of diverticula seems to be influenced by age and genetic factors. The study suggests a connection with cardiometabolic risk factors. To gain a better understanding of the role of metabolic risk factors in asymptomatic diverticulosis, targeted studies are necessary based on these findings.
Topics: Humans; Diverticulum; Hypertension; Obesity; Risk Factors; Liver Diseases
PubMed: 37725283
DOI: 10.1007/s00384-023-04532-4 -
BMJ Case Reports Jul 2014We present the case of a 77-year-old woman who initially presented 13 years ago to a colorectal clinic with a change in bowel habit and bleeding per rectum over 7...
We present the case of a 77-year-old woman who initially presented 13 years ago to a colorectal clinic with a change in bowel habit and bleeding per rectum over 7 months. These symptoms were attributed to a tubulovillous rectal adenoma which was excised transanally, but recurred five times in 12 years. The most recent endoscopy showed recurrence of the rectal adenoma and a new rectal diverticulum. Diverticula in the rectum are rare and only a few reports of this condition exist in the literature. Repeated surgical resections and endoscopic polypectomies may have caused a weakness in the rectal wall and led to a pseudodiverticulum.
Topics: Adenoma, Villous; Aged; Diverticulum; Diverticulum, Colon; Endoscopy; Female; Humans; Intestinal Polyps; Neoplasm Recurrence, Local; Rectal Diseases; Rectal Neoplasms
PubMed: 25006050
DOI: 10.1136/bcr-2013-201888 -
The New England Journal of Medicine Nov 2017
Topics: Aged; Deglutition Disorders; Esophagus; Humans; Laryngopharyngeal Reflux; Male; Radiography; Zenker Diverticulum
PubMed: 29171816
DOI: 10.1056/NEJMicm1701620 -
Clinical Gastroenterology and... Aug 2021
Topics: Deglutition Disorders; Diverticulum; Diverticulum, Esophageal; Humans; Laparoscopy
PubMed: 32289538
DOI: 10.1016/j.cgh.2020.04.011 -
The Journal of Thoracic and... Feb 2016
Topics: Aorta, Thoracic; Brachiocephalic Trunk; Decompression, Surgical; Diverticulum; Humans; Male; Replantation; Tracheal Stenosis; Vascular Malformations; Vascular Surgical Procedures
PubMed: 26614416
DOI: 10.1016/j.jtcvs.2015.10.084 -
PloS One 2021The etiology of diverticulosis is still poorly understood. However, in patients with diverticulitis, markers of mucosal inflammation and microbiota alterations have been...
INTRODUCTION
The etiology of diverticulosis is still poorly understood. However, in patients with diverticulitis, markers of mucosal inflammation and microbiota alterations have been found. The aim of this study was to evaluate potential differences of the gut microbiota composition and mucosal immunity between patients with asymptomatic diverticulosis and controls.
METHODS
We performed a prospective study on patients who underwent routine colonoscopy for causes not related to diverticular disease or inflammatory bowel disease. Participants were grouped based on the presence or absence of diverticula. Mucosal biopsies were obtained from the sigmoid and transverse colon. Microbiota composition was analyzed with IS-pro, a 16S-23S based bacterial profiling technique. To predict if patients belonged to the asymptomatic diverticulosis or control group a partial least squares discriminant analysis (PLS-DA) regression model was used. Inflammation was assessed by neutrophil and lymphocyte counts within the taken biopsies.
RESULTS
Forty-three patients were enrolled. Intestinal microbiota profiles were highly similar within individuals for all phyla. Between individuals, microbiota profiles differed substantially but regardless of the presence (n = 19) of absence (n = 24) of diverticula. Microbiota diversity in both sigmoid and transverse colon was similar in all participants. We were not able to differentiate between diverticulosis patients and controls with a PLS-DA model. Mucosal lymphocyte counts were comparable among both groups; no neutrophils were detected in any of the studied biopsies.
CONCLUSIONS
Microbiota composition and inflammatory markers were comparable among asymptomatic diverticulosis patients and controls. This suggests that the gut microbiota and mucosal inflammation do not play a major role in the pathogenesis of diverticula formation.
Topics: Aged; Asymptomatic Diseases; Colon, Sigmoid; Colonoscopy; Diverticulum; Female; Gastrointestinal Microbiome; Humans; Immunity, Mucosal; Inflammation; Male; Middle Aged; RNA, Ribosomal, 16S
PubMed: 34492052
DOI: 10.1371/journal.pone.0256657 -
Journal of Gastroenterology and... Jul 2023The role of the microbiota in diverticulosis and diverticular disease is underexplored. This systematic review aimed to assess all literature pertaining to the... (Review)
Review
BACKGROUND AND AIMS
The role of the microbiota in diverticulosis and diverticular disease is underexplored. This systematic review aimed to assess all literature pertaining to the microbiota and metabolome associations in asymptomatic diverticulosis, symptomatic uncomplicated diverticular disease (SUDD), and diverticulitis pathophysiology.
METHODS
Seven databases were searched for relevant studies published up to September 28, 2022. Data were screened in Covidence and extracted to Excel. Critical appraisal was undertaken using the Newcastle Ottawa Scale for case/control studies.
RESULTS
Of the 413 papers screened by title and abstract, 48 full-text papers were reviewed in detail with 12 studies meeting the inclusion criteria. Overall, alpha and beta diversity were unchanged in diverticulosis; however, significant changes in alpha diversity were evident in diverticulitis. A similar Bacteroidetes to Firmicutes ratio compared with controls was reported across studies. The genus-level comparisons showed no relationship with diverticular disease. Butyrate-producing microbial species were decreased in abundance, suggesting a possible contribution to the pathogenesis of diverticular disease. Comamonas species was significantly increased in asymptomatic diverticulosis patients who later developed diverticulitis. Metabolome analysis reported significant differences in diverticulosis and SUDD, with upregulated uracil being the most consistent outcome in both. No significant differences were reported in the mycobiome.
CONCLUSION
Overall, there is no convincing evidence of microbial dysbiosis in colonic diverticula to suggest that the microbiota contributes to the pathogenesis of asymptomatic diverticulosis, SUDD, or diverticular disease. Future research investigating microbiota involvement in colonic diverticula should consider an investigation of mucosa-associated microbial changes within the colonic diverticulum itself.
Topics: Humans; Diverticulum, Colon; Diverticulosis, Colonic; Microbiota; Diverticulitis; Diverticular Diseases
PubMed: 36775316
DOI: 10.1111/jgh.16142 -
Alimentary Pharmacology & Therapeutics Sep 2015The incidence of diverticulosis and diverticular disease of the colon, including diverticulitis, is increasing worldwide, and becoming a significant burden on national... (Review)
Review
BACKGROUND
The incidence of diverticulosis and diverticular disease of the colon, including diverticulitis, is increasing worldwide, and becoming a significant burden on national health systems. Treatment of patients with diverticulosis and DD is generally based on high-fibre diet and antibiotics, respectively. However, new pathophysiological knowledge suggests that further treatment may be useful.
AIM
To review the current treatment of diverticulosis and diverticular disease.
METHODS
A search of PubMed and Medline databases was performed to identify articles relevant to the management of diverticulosis and diverticular disease. Major international conferences were also reviewed.
RESULTS
Two randomised controlled trials (RCT) found the role of antibiotics in managing acute diverticulitis to be questionable, particularly in patients with no complicating comorbidities. One RCT found mesalazine to be effective in preventing acute diverticulitis in patients with symptomatic uncomplicated diverticular disease. The role of rifaximin or mesalazine in preventing diverticulitis recurrence, based on the results of 1 and 4 RCTs, respectively, remains unclear. RCTs found rifaximin and mesalazine to be effective in treating symptomatic uncomplicated diverticular disease. The use of probiotics in diverticular disease and in preventing acute diverticulitis occurrence/recurrence appears promising but unconclusive. Finally, the role of fibre in treating diverticulosis remains unclear.
CONCLUSIONS
Available evidence suggests that antibiotics have a role only in the treatment of complicated diverticulitis. It appears to be some evidence for a role for rifaximin and mesalazine in treating symptomatic uncomplicated diverticular disease. Finally, there is not currently adequate evidence to recommend any medical treatment for the prevention of diverticulitis recurrence.
Topics: Anti-Bacterial Agents; Dietary Fiber; Diverticulitis, Colonic; Diverticulum; Humans; Mesalamine; Probiotics; Randomized Controlled Trials as Topic; Recurrence; Rifamycins; Rifaximin
PubMed: 26202723
DOI: 10.1111/apt.13322