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Advances in Kidney Disease and Health Sep 2023Autosomal dominant polycystic kidney disease is the most commonly inherited disease of the kidneys affecting an estimated 12,000,000 people in the world. Autosomal... (Review)
Review
Autosomal dominant polycystic kidney disease is the most commonly inherited disease of the kidneys affecting an estimated 12,000,000 people in the world. Autosomal dominant polycystic kidney disease is a systemic disease, with a wide range of associated features that includes hypertension, valvular heart diseases, cerebral aneurysms, aortic aneurysms, liver cysts, abdominal hernias, diverticulosis, gross hematuria, urinary tract infections, nephrolithiasis, pancreatic cysts, and seminal vesicle cysts. The cardiovascular anomalies are somewhat different than in the general population and also chronic kidney disease population, with higher morbidity and mortality rates. This review will focus on cardiovascular diseases associated with autosomal dominant polycystic kidney disease and their management.
Topics: Humans; Polycystic Kidney, Autosomal Dominant; Cardiovascular Diseases; Hypertension; Kidney; Cysts
PubMed: 38097332
DOI: 10.1053/j.akdh.2023.03.004 -
Frontiers in Medicine 2024Jejunal diverticulosis is a rare condition. Most of the time, it is asymptomatic; but it can cause severe complications such as intestinal perforation, mechanical... (Review)
Review
INTRODUCTION
Jejunal diverticulosis is a rare condition. Most of the time, it is asymptomatic; but it can cause severe complications such as intestinal perforation, mechanical occlusion, and hemorrhage.
CASE PRESENTATION
A patient aged 78 years, with a history of biological aortic valve prosthesis, atrial fibrillation, type 2 diabetes mellitus, and chronic obstructive pulmonary disease, presented in the emergency department for acute abdominal pain in the lower abdominal floor, nausea, and inappetence. Abdominal computed tomography revealed an inflammatory block in the hypogastrium, agglutinated small intestinal loops, fecal stasis, and air inclusions. Pulled mesentery and associated internal hernia are suspected. Exploratory laparotomy was performed, revealing an inflammatory block in the hypogastrium, whose dissection revealed inner purulent collection and the appearance of jejunal diverticulitis, a diagnosis confirmed by histopathological examination. Segmental resection of the jejunum with double-layer terminal-terminal enteroenteric anastomosis, lavage, and drainage was performed. The evolution was favorable.
CONCLUSION
Based on our brief review, the diagnosis of complicated jejunal diverticulosis is difficult and sometimes not accurately established, even by high-resolution imaging techniques, with diagnostic laparotomy being necessary for these situations. Surgical treatment should be considered before severe complications develop.
PubMed: 38818398
DOI: 10.3389/fmed.2024.1413254 -
Journal of Clinical Medicine Mar 2024: The complications associated with Meckel's diverticulum (MD) are well-known. However, blunt injuries regarding MD have not been widely described in the literature....
: The complications associated with Meckel's diverticulum (MD) are well-known. However, blunt injuries regarding MD have not been widely described in the literature. This was the reason for undertaking research on MD lesions. : The materials consisted of 28 cases of damage to MD after blunt trauma published during the years 1921-2022. The collected data were subjected to statistical analysis. : The following MD injuries have been identified, starting with the most common isolated perforation of MD, bleeding from the area of MD, perforation of MD with concomitant tearing of the mesentery intestines and bleeding, intussusception of MD, and intramural hematoma of MD with adjacent mesenteric hematoma. Most injuries were caused by a traffic accident, followed by sports, accidents at work, and then violence. Almost all the cases (27) involved men. Several possible mechanisms may contribute to post-traumatic damage to MD. First of all, they are associated with abdominal compression and a secondary increase in intra-abdominal pressure as well as with the action of shearing forces during deceleration. : Traumatic MD injuries are differentiated and very rare. They can coexist with other serious injuries to the abdominal organs.
PubMed: 38541840
DOI: 10.3390/jcm13061614 -
Asian Journal of Surgery Sep 2023
Topics: Humans; Diverticulum, Esophageal; Tomography, X-Ray Computed
PubMed: 37055251
DOI: 10.1016/j.asjsur.2023.03.183 -
American Journal of Clinical Pathology May 2024The appendix, although considered a vestigial organ, is of considerable clinical importance because acute appendicitis is a common medical problem. There are also other... (Review)
Review
OBJECTIVES
The appendix, although considered a vestigial organ, is of considerable clinical importance because acute appendicitis is a common medical problem. There are also other disease processes involving the appendix. The appendix is among the first specimens that the pathologist (and surgeon) cuts one's teeth on. Thus, there may be a tendency to underestimate the clinically and prognostically significant appendiceal pathologies.
METHODS
We provide a vade mecum of the pathologic features of a wide range of nonneoplastic appendiceal pathologies, with an emphasis on developing a practical approach to grossing, microscopy, and reporting-all with clinical and therapeutic implications. Much of this is based on literature on MEDLINE with reference to years 2008 to 2023, as well as on personal experiences and interpretations.
RESULTS
The appendix can harbor a myriad of nonneoplastic pathologies, including infections, inflammations of varying etiologies (including interval appendectomy), endometriosis, diverticulosis, and so on. Chronic appendicitis, Crohn disease, and clinical audit are recurring themes while COVID-19 is a new entity.
CONCLUSIONS
Most importantly, all pathologists should appreciate that the appendix is not as "routine" a specimen as one would want to believe.
Topics: Humans; Appendix; COVID-19; Appendicitis; Cecal Diseases; SARS-CoV-2
PubMed: 38217538
DOI: 10.1093/ajcp/aqad175 -
United European Gastroenterology Journal Sep 2023The Diverticular Inflammation and Complication Assessment (DICA) classification and the Combined Overview on Diverticular Assessment (CODA) were found to be effective in...
Diverticular Inflammation and Complication Assessment classification, CODA score and fecal calprotectin in clinical assessment of patients with diverticular disease: A decision curve analysis.
BACKGROUND AND AIMS
The Diverticular Inflammation and Complication Assessment (DICA) classification and the Combined Overview on Diverticular Assessment (CODA) were found to be effective in predicting the outcomes of Diverticular Disease (DD). We ascertain whether fecal calprotectin (FC) can further aid in improving risk stratification.
METHODS
A three-year international, multicentre, prospective cohort study was conducted involving 43 Gastroenterology and Endoscopy centres. Survival methods for censored observations were used to estimate the risk of acute diverticulitis (AD) in newly diagnosed DD patients according to basal FC, DICA, and CODA. The net benefit of management strategies based on DICA, CODA and FC in addition to CODA was assessed with decision curve analysis, which incorporates the harms and benefits of using a prognostic model for clinical decisions.
RESULTS
At the first diagnosis of diverticulosis/DD, 871 participants underwent FC measurement. FC was associated with the risk of AD at 3 years (HR per each base 10 logarithm increase: 3.29; 95% confidence interval, 2.13-5.10) and showed moderate discrimination (c-statistic: 0.685; 0.614-0.756). DICA and CODA were more accurate predictors of AD than FC. However, FC showed high discrimination capacity to predict AD at 3 months, which was not maintained at longer follow-up times. The decision curve analysis comparing the combination of FC and CODA with CODA alone did not clearly indicate a larger net benefit of one strategy over the other.
CONCLUSIONS
FC measurement could be used as a complementary tool to assess the immediate risk of AD. In all other cases, treatment strategies based on the CODA score alone should be recommended.
Topics: Humans; Diverticulosis, Colonic; Colonoscopy; Leukocyte L1 Antigen Complex; Prospective Studies; Diverticular Diseases; Diverticulum; Inflammation
PubMed: 37550901
DOI: 10.1002/ueg2.12369 -
Journal of Postgraduate Medicine 2024
Topics: Humans; Heart Defects, Congenital; Heart Ventricles; Diverticulum
PubMed: 37530375
DOI: 10.4103/jpgm.jpgm_119_23 -
Mayo Clinic Proceedings Jan 2024
Topics: Humans; Esophageal Achalasia; Diverticulum, Esophageal
PubMed: 38176817
DOI: 10.1016/j.mayocp.2023.08.002 -
The American Journal of Gastroenterology Feb 2024
PubMed: 38305292
DOI: 10.14309/ajg.0000000000002683 -
Academic Radiology Nov 2023An anatomic association between ductus diverticulum and the primary entry tear in type B aortic dissection was observed. The aim was to reveal the association between...
RATIONALE AND OBJECTIVES
An anatomic association between ductus diverticulum and the primary entry tear in type B aortic dissection was observed. The aim was to reveal the association between ductus diverticulum and acute type B aortic dissection.
MATERIALS AND METHODS
A matched case-control study was conducted. Case subjects were extracted from consecutive patients with aortic dissection in the emergency department during 2019; the control subjects were extracted from consecutive patients without major aortic disease during 2019. 1:1 matching was performed for age, sex, and comorbidity, the prevalence of ductus diverticulum was compared, and conditional logistic regression was performed to reveal the association of ductus diverticulum and acute type B aortic dissection. In addition, the anatomic association between the ductus diverticulum and the primary entry tear was assessed in extracted cases, and baseline parameters were compared between dissection patients with or without ductus diverticulum.
RESULTS
128 cases and 402 control subjects were extracted. 86 pairs were formed after matching, and the proportion of ductus diverticulum (19.8% vs 1.2%, p < 0.001) was higher in the case group. Conditional logistic regression revealed ductus diverticulum(OR = 22.04, 95%CI: 2.81-172.76, p = 0.003) as an independent predictor for acute type B aortic dissection. Besides, the ductus diverticulum has an anatomic association with the primary entry tear (OR = 4.22, 95%CI: 1.46-12.25, p = 0.008), and dissection patients with ductus diverticulum were younger (47.9 vs 54.4, p = 0.015) than dissection patients without ductus diverticulum.
CONCLUSION
Ductus diverticulum is common in acute type B aortic dissection and is independently associated with acute type B aortic dissection.
Topics: Humans; Case-Control Studies; Aortic Dissection; Aortic Diseases; Diverticulum; Retrospective Studies; Acute Disease
PubMed: 36754645
DOI: 10.1016/j.acra.2023.01.015