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Minerva Medica Oct 2017The incidence of diverticulosis and diverticular disease (DD) of the colon, including acute diverticulitis, is increasing worldwide, and becoming a significant burden on... (Review)
Review
The incidence of diverticulosis and diverticular disease (DD) of the colon, including acute diverticulitis, is increasing worldwide, and becoming a significant burden on national health systems in terms of direct and indirect costs. Thus, significant efforts are now being focused to identify the correct therapeutic approach to treat symptomatic patients and to prevent diverticulitis. Fiber, non-absorbable antibiotics, 5-aminosalicylic acid and probioticsare currently being investigated in this way. Unfortunately, current evidences on the effectiveness of some medical treatment in preventing acute diverticulitis recurrence are still lacking. The effectiveness and the future perspectives of these treatments are discussed herein.
Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Dietary Fiber; Diverticulum; Humans; Incidence; Italy; Mesalamine; Probiotics; Treatment Outcome
PubMed: 28466633
DOI: 10.23736/S0026-4806.17.05201-6 -
Current Gastroenterology Reports Jan 2020Small bowel diverticulosis is a well-known clinical entity whose diagnosis and management has evolved in recent years. This review covers pathophysiology, incidence, and... (Review)
Review
PURPOSE OF REVIEW
Small bowel diverticulosis is a well-known clinical entity whose diagnosis and management has evolved in recent years. This review covers pathophysiology, incidence, and prevalence, and it also provides an update on modern diagnosis and management. Meckel's diverticula are covered elsewhere in this volume.
RECENT FINDINGS
CT scan and MRI have largely supplanted barium follow-through for diagnosis. No intervention is needed in asymptomatic individuals. Endoscopic management is playing an increasing role for both bleeding and resection of intraduodenal diverticula, but surgical intervention remains the only definitive intervention for other complications like diverticulitis and small bowel obstruction. Small bowel diverticulosis is an uncommon condition which is associated with numerous possible complications. While endoscopy is playing an increasingly large role in management, surgical resection remains the treatment of choice for most complications. A high index of suspicion is needed in order to diagnose this entity.
Topics: Diverticulum; Humans; Intestinal Diseases; Intestine, Small
PubMed: 31940112
DOI: 10.1007/s11894-019-0741-2 -
Acta Gastro-enterologica Belgica 2018Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations. The majority of cases are discovered incidentally during radiological... (Review)
Review
Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations. The majority of cases are discovered incidentally during radiological investigations. Based on a case of a 77 year old woman with jejunal diverticulitis, the current literature about small bowel diverticulosis is reviewed. A jejunoileal diverticulum is usually uncomplicated and can be treated conservatively. Serious complications that require surgery can occur. Abdominal CT is the preferred diagnostic tool.
Topics: Abdominal Pain; Aged; Diverticulitis; Diverticulum; Female; Humans; Ileal Diseases; Intestine, Small; Jejunal Diseases; Vomiting
PubMed: 30645921
DOI: No ID Found -
Medicina 2020
Topics: Diverticulum; Humans
PubMed: 32841144
DOI: No ID Found -
American Journal of Surgery Oct 1969
Review
Topics: Age Factors; Aged; Diverticulum; Female; Gastrointestinal Hemorrhage; Humans; Intestinal Perforation; Jejunum; Malabsorption Syndromes; Male; Middle Aged; Radiography; Sex Factors
PubMed: 4980675
DOI: 10.1016/0002-9610(69)90197-4 -
BMC Surgery Jun 2019Jejunal diverticula are the rarest of all small bowel diverticula. Most patients with jejunal diverticula are asymptomatic. Major complications include diverticulitis,... (Review)
Review
BACKGROUND
Jejunal diverticula are the rarest of all small bowel diverticula. Most patients with jejunal diverticula are asymptomatic. Major complications include diverticulitis, gastrointestinal hemorrhage, intestinal obstruction and perforation. The hemorrhage has been attributed to diverticulitis with ulceration, diverticulosis associated with trauma and irritation disorder. However, only six cases reported the arteriovenous malformations within jejunal diverticulosis to be the cause of hemorrhage.
CASE PRESENTATION
We present a case of arteriovenous malformations within jejunal diverticulosis in a 68-year-old male presented with lower gastrointestinal bleeding. After admission and stabilization, upper and lower endoscopies were performed without demonstrating the bleeding site. They only revealed clotted and red blood throughout the colon. Technetium-labeled red blood cell bleeding scan, endoscopic capsule, and selective angiography were performed to localize the site of bleeding without significant findings. As the clinical status of the patient deteriorated, exploratory laparotomy was performed urgently. Extensive jejunal saccular pouches were found 10 cm distal to duodenojejunal junction extending 1.6 m distally. Segmental resection was performed with side to side primary anastomosis. Microscopic examination of the specimen revealed many diverticula. He was followed up 2 years after that without complications.
CONCLUSION
We report yet the seventh case jejunal diverticulosis with the presence of angiodysplasia, in hope of expanding the knowledge of a rare occurrence and increasing the demand for further research about the etiology, clinical impact and treatment of such anomalies coexistence. This case also highlights the importance of considering the diagnosis of AVMs within jejunal diverticulosis in the presence of uncontrollable blood loss in the pre- or intra- operatively diagnosed jejunal diverticulosis and the urgent need for surgical intervention. In addition, the diagnostic tests should be performed close to the bleeding episode.
Topics: Aged; Arteriovenous Malformations; Diverticulum; Gastrointestinal Hemorrhage; Humans; Jejunal Diseases; Laparotomy; Male
PubMed: 31248400
DOI: 10.1186/s12893-019-0538-0 -
Gastroenterologia Y Hepatologia 2017
Review
Topics: Abdominal Pain; Aged, 80 and over; Diverticulum; Fatal Outcome; Humans; Intestinal Obstruction; Ischemia; Jejunal Diseases; Jejunum; Male; Postoperative Complications; Pulmonary Edema
PubMed: 27270086
DOI: 10.1016/j.gastrohep.2016.04.016 -
Orvosi Hetilap May 2018Diverticulitis of the vermiform appendix is a rare disease with clinical features often similar to conventional acute appendicitis. The importance of appendiceal... (Review)
Review
Diverticulitis of the vermiform appendix is a rare disease with clinical features often similar to conventional acute appendicitis. The importance of appendiceal diverticulosis is the fact that it can lead to an early and a higher incidence of perforation and therefore a higher mortality rate, in contrast to acute appendicitis alone. In this study we present the clinicopathology, diagnosis and therapy of the disease with a review of the literature. A 65-year-old woman presented to the emergency department with a 48-hour history of intermittent pain in the right iliac fossa. Abdominal ultrasound raised the possibility of acute appendicitis but because of the relative asymptomatic state of the patient, the lack of fever and rebound tenderness we started observation. After 2 days with episodic abdominal pain, the patient was taken to the operating theatre for laparoscopic exploration. Intraoperatively, multiple diverticula were noted on the appendix and appendectomy was performed. Histopathological examination revealed diverticulosis and inflammation of the appendiceal wall. Due to the possible complications, the difficult preoperative diagnosis and its frequent association with appendiceal neoplasm, appendiceal diverticulosis requires special attention. For asymptomatic cases, incidentally diagnosed intraoperatively or discovered by radiology prophylactic appendectomy is recommended. Orv Hetil. 2018; 159(19): 768-772.
Topics: Acute Disease; Appendectomy; Appendicitis; Appendix; Diverticulitis; Diverticulum; Female; Humans; Middle Aged
PubMed: 29730945
DOI: 10.1556/650.2018.31010 -
Der Internist Jun 2005Alterations in the colon wall, motility disorders, and certain nutritional habits are the essential factors in the development of colon diverticula. Thus, with advancing... (Review)
Review
Alterations in the colon wall, motility disorders, and certain nutritional habits are the essential factors in the development of colon diverticula. Thus, with advancing age this results in a high incidence in Western industrialized countries. The clinical picture is usually one of symptom-free diverticulosis. Diverticular disease can be associated with minor symptoms, but in complicated cases with diverticulitis and diverticular hemorrhage, it is potentially fatal. Further complications include abscess formation, fistula development, and obstruction. Barium double-contrast imaging exhibits the highest diagnostic sensitivity in diverticulosis but is contraindicated in cases of suspected complicated diverticular disease due to the danger of perforation. In these instances, sonography, computed tomography, or magnetic resonance imaging are performed. For diverticular hemorrhage, coloscopy not only represents a possible diagnostic tool but also a therapeutic option for various techniques of hemostasis. Treatment of diverticulitis and its complications requires careful consideration of conservative and surgical approaches and close interdisciplinary cooperation.
Topics: Diverticulitis; Diverticulum; Humans; Practice Guidelines as Topic; Practice Patterns, Physicians'
PubMed: 15875148
DOI: 10.1007/s00108-005-1403-z -
JAMA Sep 2016
Topics: Diverticulitis; Diverticulum; Humans
PubMed: 27623476
DOI: 10.1001/jama.2016.3592