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International Journal of Surgery Case... Jun 2024Paraduodenal hernias are difficult to diagnose due to their unusual presentation. Herein, five new cases are added to the literature.
INTRODUCTION AND IMPORTANCE
Paraduodenal hernias are difficult to diagnose due to their unusual presentation. Herein, five new cases are added to the literature.
CASE PRESENTATION
Four male and one female child complained of paraduodenal hernias, two on the right side and three on the left side. The intestinal part that herniated inside the hernia sac was also malrotated in four patients. One patient had Meckel's diverticulum with a herniated intestine. One infant had extrahepatic biliary disease, a single atrium, polysplenia, intestinal malrotation, and a left paraduodenal hernia. Exploratory labarotomy was done for reduction of the intestine, reorientation, and repair of hernia orifices.
CLINICAL DISCUSSION
Paraduodenal hernia is a component of malrotation. Cautious dissection of the hernia orifice is required to keep away from injuries to the inferior mesenteric vein or left colic artery in the course of the restoration of the left paraduodenal hernia. Also, the superior mesenteric vessels may be injured in the course of the restoration of the right paraduodenal hernia.
CONCLUSION
There is a correlation between the occurrence of PDH with malrotation. The diagnosis of malrotation can be made with an ultrasound abdomen; however, it is true that ultrasound cannot make a confirmed diagnosis in all patients. Once the diagnosis of a mesocolic hernia has occurred, surgical repair is mandatory by closure of the defect.
PubMed: 38714067
DOI: 10.1016/j.ijscr.2024.109696 -
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 -
Medicina (Kaunas, Lithuania) Jan 2024Small bowel non-Meckelian diverticulosis is a rare condition with only a few published cases despite being described over 200 years ago. In the midst of the COVID-19... (Review)
Review
Small bowel non-Meckelian diverticulosis is a rare condition with only a few published cases despite being described over 200 years ago. In the midst of the COVID-19 pandemic, studies suggested that many patients may experience gastrointestinal manifestations. Intestinal symptoms could worsen the inflammation and infection associated with small bowel diverticulitis. Here we present three cases: one with inflammation and rupture in a COVID-19 patient and another as an asymptomatic detection. The third case involved recurrence after the first laparoscopic lavage approach. Furthermore, we provide a mini-review of the literature to emphasize the importance of considering this entity in the differential diagnosis of an acute abdomen. In the majority of cases involving small bowel diverticula, conservative management is the preferred approach. However, when complications arise, surgical intervention, including enteroctomy and primary anastomosis, may be necessary to achieve optimal outcomes.
Topics: Humans; Pandemics; COVID-19; Diverticulum; Diverticulitis; Inflammation
PubMed: 38399517
DOI: 10.3390/medicina60020229 -
Case Reports in Surgery 2023The incidence of colonic diverticulosis has risen significantly. Diverticular disease is the most frequent cause of colovesical fistulas, which are uncommon...
INTRODUCTION
The incidence of colonic diverticulosis has risen significantly. Diverticular disease is the most frequent cause of colovesical fistulas, which are uncommon complications of diverticulitis. Clinical signs, such as fecaluria and pneumaturia, are typically required to confirm its presence. Finding the cause of the disease so that the proper therapy can be started is the primary goal of a diagnostic workup rather than observing the fistula tract itself. . We present a 43-year-old man complaining of frequent urinary tract infections for six months. On CT abdomen and pelvis, a colovesical fistula was diagnosed. Surgery was performed, and after the division between the sigmoid colon and the bladder, a sigmoidectomy and an end-to-end colorectal anastomosis were performed. During the surgery, the fistula tract was not detected. The patient was discharged in excellent condition on day six, and the catheter was removed on day 10.
CONCLUSION
In conclusion, as in our case, any patient with a urinary tract infection should be suspected of having this condition, especially if he has persistent symptoms that have not responded to standard medical care. Patients who present with fecaluria, pneumaturia, and other specific symptoms of a colovesicular fistula do not necessarily need a barium enema or cystography to confirm the presence of the fistula.
PubMed: 38090132
DOI: 10.1155/2023/8835222 -
Cureus Dec 2023Appendicular diverticulitis (AD) is a rare entity characterized by the inflammation of the arising diverticulum of the appendix. It has been reported to carry a high...
Appendicular diverticulitis (AD) is a rare entity characterized by the inflammation of the arising diverticulum of the appendix. It has been reported to carry a high risk of perioperative complications, such as bleeding and perforation. Furthermore, multiple articles have highlighted the importance of diagnosing AD early due to its strong association with malignancies. Limited published cases concerning AD in our country and globally are available in the literature. Hence, we present in this article a case series of five exciting cases of incidental findings of AD that were initially diagnosed as acute appendicitis based on clinical evaluation and imaging findings. In our series, we performed a retrograde evaluation of the computed tomography scans of all five cases that showed diverticula. In conclusion, histopathological evaluation remains the method of choice to reach the definitive diagnosis; however, it is essential to highlight the relevance of imaging in diagnosing AD preoperatively in the early stages to reduce morbidity and mortality.
PubMed: 38283468
DOI: 10.7759/cureus.51214 -
Endoscopy Dec 2023
Topics: Humans; Diverticulum; Endoscopy
PubMed: 37714211
DOI: 10.1055/a-2155-4535 -
Endoscopy Dec 2023
Topics: Humans; Zenker Diverticulum; Esophagoscopy; Myotomy
PubMed: 37040881
DOI: 10.1055/a-2045-7541 -
Endoscopy Sep 2023
Topics: Humans; Zenker Diverticulum; Myotomy
PubMed: 37643601
DOI: 10.1055/a-2113-2824 -
Cureus Jul 2023We present a rare case of bilateral pharyngocoeles in a patient with symptomatic neck swelling prominently seen with the Valsalva manoeuvre. Pharyngocoeles have only...
We present a rare case of bilateral pharyngocoeles in a patient with symptomatic neck swelling prominently seen with the Valsalva manoeuvre. Pharyngocoeles have only been reported a handful of times in the literature. Due to their rarity, they can easily be misdiagnosed as a laryngocoele, Zenker's diverticulum, or jugular venous phlebectasia. The diagnosis in this case was confirmed on computed tomography imaging of the neck with Valsalva performed. Our patient underwent surgical excision of the symptomatic pharyngocoele on the right side while conservative management was opted for the asymptomatic left pharyngocoele. His risk factors for developing bilateral pharyngocoeles are most likely due to the use of continuous positive airway pressure (CPAP) machine at high pressures coupled with pharyngeal wall weakness. To our knowledge, this is the first case of pharyngocoeles associated with CPAP machine use. It is important to perform a thorough assessment to appropriately diagnose and treat patients with this anatomical anomaly.
PubMed: 37663982
DOI: 10.7759/cureus.42762 -
Medicina (Kaunas, Lithuania) Nov 2023: Diverticulosis affects a significant portion of the elderly population, with age and lifestyle being established risk factors. Additionally, genetic predisposition is...
: Diverticulosis affects a significant portion of the elderly population, with age and lifestyle being established risk factors. Additionally, genetic predisposition is gaining recognition as a contributing factor. This pilot study sought to explore the frequency of genetic variants in matrix metalloproteinases (MMPs) 3, 9, and 12 in a population of colonic diverticulosis patients. : The study encompassed 134 participants: 59 diagnosed with colon diverticulosis during colonoscopy and 75 healthy controls. The cases and controls were meticulously matched in terms of age and gender. We assessed the distribution of genetic variants rs3025058, rs3918242, and rs2276109 using the polymerase chain reaction-restriction fragments length polymorphism technique. : The rs3918242 allele T was notably more frequent in individuals with diverticulosis when compared with the control group ( < 0.03). Furthermore, it was associated with dominant (OR = 2.62; 95% CI: 1.24-5.56; < 0.01) and co-dominant (OR = 2.10; 95% CI: 1.06-4.13; < 0.03) genetic models. The rs3025058 5A/5A genotype was nearly twice as frequent in patients with diverticulosis, while the 6A/6A genotype was only half as common in this group. Conversely, no significant correlation was established between rs2276109 and colonic diverticulosis. : Our study offers the first insight into a potential connection between genetic variants in MMPs and colon diverticulosis. Specifically, allele T of rs3918242 and allele 5A of rs3025058 appear to be linked to this condition. These findings indirectly suggest a role for extracellular matrix proteins in the pathogenesis of diverticulosis.
Topics: Aged; Humans; Case-Control Studies; Diverticulosis, Colonic; Diverticulum; Genetic Predisposition to Disease; Genotype; Matrix Metalloproteinase 12; Matrix Metalloproteinase 3; Matrix Metalloproteinase 9; Pilot Projects; Polymorphism, Single Nucleotide
PubMed: 38004080
DOI: 10.3390/medicina59112031