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The Journal of Surgical Research Dec 2022The true prevalence and pathogenesis of diverticulosis is poorly understood. Risk factors for diverticulosis are presently unclear, with most clinicians attributing its...
INTRODUCTION
The true prevalence and pathogenesis of diverticulosis is poorly understood. Risk factors for diverticulosis are presently unclear, with most clinicians attributing its development to years of chronic constipation. Previous studies have been limited by their failure to include young, ethnically diverse patient populations.
METHODS
Patients who presented to the emergency department of our hospital from January-September 2019 and underwent abdominal computerized tomography (CT) scan for the evaluation of appendicitis were included. CT's were reviewed for the presence of diverticulosis. Risk factors for diverticulosis were determined for two age groups: >40 and ≤ 40.
RESULTS
A total of 359 patients were included in the study. The median age was 38.57.1% were male. 81.6% were Hispanic. 43.5% had colonic diverticulosis on CT. 198 patients (55.1%) were ≤ age 40. The rate of diverticulosis in this group was 35.3% (n = 70). Those with diverticulosis were not significantly older (median age 29 versus 27, P = 0.061) but had a higher median body mass index (BMI) (28.4 versus 25.3, P = 0.003) compared to those without diverticulosis. On multivariate analysis, no characteristics were associated with the presence of diverticulosis for this group. Over age 40, 53.4% of patients (n = 86) had diverticulosis. Patients with diverticulosis were more likely to be Hispanic (95.3% versus 73.3%, P ≤ 0.001), less likely to be Asian (2.4% versus 16.0%, P = 0.004), had a higher median BMI (28.7 versus 25.5, P ≤ 0.001), and were more likely to use alcohol (30.2% versus 14.7%, P = 0.024) than those without diverticulosis. On multivariate analysis, characteristics associated with the presence of diverticulosis were BMI >30 (odds ratio OR 2.22, 95% confidence interval CI 1.03-4.80), Hispanic ethnicity (OR 10.05, 95% CI 1.74-58.26), and alcohol use (OR 3.44, 95% CI 1.26-9.39).
CONCLUSIONS
There was a higher rate of asymptomatic diverticulosis in the <40 cohort than previously reported in the literature. Obesity, alcohol use, and Hispanic ethnicity were associated with the presence of diverticulosis in patients > age 40, but no risk factors for diverticulosis were identified for patients ≤ age 40, suggesting that diverticular pathogenesis may differ by age. Constipation was not a risk factor for diverticulosis in either age group. The data regarding the prevalence of diverticulosis in Hispanic patients is lacking and should be the focus of future inquiry.
Topics: Humans; Male; Adult; Female; Prevalence; Colonoscopy; Diverticulosis, Colonic; Risk Factors; Diverticulum; Constipation
PubMed: 36037611
DOI: 10.1016/j.jss.2022.07.021 -
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 -
Journal of Bronchology & Interventional... Oct 2014Multiple tracheal diverticulosis is a rare clinical entity. Tracheal diverticula are usually recognized radiologically as solitary right paratracheal air collections on...
Multiple tracheal diverticulosis is a rare clinical entity. Tracheal diverticula are usually recognized radiologically as solitary right paratracheal air collections on thoracic computed tomography examination. They are usually asymptomatic but can occasionally present with persistent symptoms. We herein report the case of a 50-year-old male patient who underwent extensive evaluation for persistent cough. Multiple posterior right paratracheal air collections were recognized on thoracic multidetector computed tomography examination, which was confirmed as multiple-acquired posterior upper tracheal diverticula on flexible bronchoscopy. The patient improved with conservative medical management.
Topics: Bronchoscopy; Diverticulum; Humans; Male; Middle Aged; Radiography; Tomography Scanners, X-Ray Computed; Tracheal Diseases
PubMed: 25321454
DOI: 10.1097/LBR.0000000000000091 -
PloS One 2019Diverticulosis and colorectal neoplasia share epidemiological trends and risk factors which are common in Western countries and incidences increase with age. However,... (Meta-Analysis)
Meta-Analysis
BACKGROUND/AIMS
Diverticulosis and colorectal neoplasia share epidemiological trends and risk factors which are common in Western countries and incidences increase with age. However, the data on an association between diverticulosis and colorectal neoplasia are conflicting. Thus, we performed a meta-analysis to evaluate whether diverticulosis is associated with colorectal neoplasia.
METHODS
A systematic literature search of PubMed, EMBASE, Cochrane Library, Web of Science, and SCOPUS was conducted to identify studies that investigated the association between diverticulosis and advanced colorectal neoplasia (advanced adenoma, colorectal cancer), adenomas, or polyps. The demographic characteristics of patients, including age, gender, indication for colonoscopy, confounding factors, and outcomes of colorectal neoplasia were assessed.
RESULTS
We identified 29 cross-sectional studies (N = 450,953) that investigated the association between diverticulosis and colorectal neoplasia. The meta-analysis found that diverticulosis was not associated with advanced colorectal neoplasia (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.63-1.50). Although there was a positive correlation between diverticulosis and adenomas (OR 1.47, 95% CI 1.18-1.84) and diverticulosis and polyps (OR 1.95, 95% CI 1.15-3.31), diverticulosis did not increase the risk of adenomas (OR 1.34, 95% CI 0.87-2.06) in patients who underwent screening colonoscopy. Moreover, all the increased risk of colorectal neoplasia in patients with diverticulosis was observed in published studies only, and not in unpublished ones.
CONCLUSIONS
This meta-analysis demonstrated that diverticulosis is not associated with an increased risk of advanced colorectal neoplasia. Although diverticulosis was associated with a higher risk of polyps and adenomas, the risk was not increased in screening populations. Moreover, the increased risk of colorectal neoplasia in patients with diverticulosis was observed only in published studies and not in unpublished ones.
Topics: Aged; Colonoscopy; Colorectal Neoplasms; Diverticulum; Female; Humans; Incidence; Middle Aged; Risk Factors
PubMed: 31141507
DOI: 10.1371/journal.pone.0216380 -
Diseases of the Colon and Rectum 1974
Review
Topics: Adolescent; Adult; Age Factors; Aged; Appendiceal Neoplasms; Appendicitis; Appendix; Cecal Diseases; Child; Colonic Diseases; Cystadenoma; Diverticulum; Female; Humans; Infant; Intestinal Obstruction; Male; Middle Aged; Radiography; Sex Factors
PubMed: 4206575
DOI: 10.1007/BF02588104 -
The Australian and New Zealand Journal... Jan 1986Eleven cases of small bowel diverticulosis are discussed. Four patients presented with perforation, five with other symptoms attributable to this condition and in two... (Review)
Review
Eleven cases of small bowel diverticulosis are discussed. Four patients presented with perforation, five with other symptoms attributable to this condition and in two patients diverticulosis was considered an incidental finding. A review of the literature suggests that small bowel diverticulosis may be: present in up to 1.3% of the population; associated with symptoms in approximately 50% of patients, and associated with acute surgical complications in 10% of patients. This may be a disorder of intestinal motility associated with colonic diverticulosis and related to other disorders of smooth muscle and myenteric plexus. Small bowel diverticulosis should not be regarded as a rare, incidental and inconsequential finding.
Topics: Abdomen, Acute; Aged; Diverticulum; Female; Gastrointestinal Motility; Humans; Intestinal Perforation; Jejunal Diseases; Male; Middle Aged
PubMed: 3090989
DOI: 10.1111/j.1445-2197.1986.tb01820.x -
Journal of the College of Physicians... Mar 2017Appendicular diverticulosis is one of the very rare diseases which is also difficult to diagnose, especially clinically, due to its silent course and non-specific...
Appendicular diverticulosis is one of the very rare diseases which is also difficult to diagnose, especially clinically, due to its silent course and non-specific symptoms. It comes under the notation usually due to its complications like diverticulitis or perforation, but sometimes it also presents with acute appendicitis. This report describes a 44-year male patient who presented with the complain of right iliac fossa pain and was clinically diagnosed as acute appendicitis; but intraoperatively, it was found that the appendix also had diverticulosis along with appendicitis.
Topics: Acute Disease; Adult; Appendectomy; Appendicitis; Appendix; Diverticulitis; Diverticulum; Humans; Male; Pelvic Pain; Rare Diseases; Treatment Outcome
PubMed: 28406778
DOI: No ID Found -
Archives of Surgery (Chicago, Ill. :... Jul 1988Forty-seven patients with jejunal diverticulosis were identified at the University California, Davis Medical Center, Sacramento, by a review of patient medical records...
Forty-seven patients with jejunal diverticulosis were identified at the University California, Davis Medical Center, Sacramento, by a review of patient medical records from 1980 to 1986. Fourteen patients had complications that could be directly attributed to the presence of diverticula. Six patients had evidence of a malabsorption syndrome and responded to administration of broad-spectrum oral antibiotics. One patient had recurrent bouts of an asymptomatic pneumoperitoneum. A total of seven patients required operative intervention for the following conditions: massive gastrointestinal tract bleeding, two patients; mechanical small-bowel obstruction, two patients; and diverticulitis with perforation, three patients. One patient died. Nineteen patients had symptoms of epigastric pain, early satiety, and bloating for which no cause other than the presence of jejunal diverticulosis was found. Jejunal diverticulosis was an incidental finding in 14 patients treated for other gastrointestinal tract problems.
Topics: Adult; Aged; Aged, 80 and over; Diverticulitis; Diverticulum; Female; Gastrointestinal Hemorrhage; Humans; Intestinal Obstruction; Intestinal Perforation; Jejunal Diseases; Malabsorption Syndromes; Male; Middle Aged; Pneumoperitoneum
PubMed: 3132909
DOI: 10.1001/archsurg.1988.01400310103018 -
The American Surgeon Aug 2010
Topics: Aged; Diverticulum; Humans; Jejunal Diseases; Male
PubMed: 20726427
DOI: No ID Found -
The Journal of Practical Nursing 2008
Topics: Abscess; Anti-Bacterial Agents; Causality; Colectomy; Dietary Fiber; Diverticulitis; Diverticulum; Gastrointestinal Hemorrhage; Humans; Intestinal Fistula; Intestinal Perforation; Menu Planning; Peritonitis; Tomography, X-Ray Computed; United States
PubMed: 19186323
DOI: No ID Found