Treatment of the acute diverticulitis: A systematic review.
[Treatment of the acute diverticulitis: A systematic review]. Presse Med. 2015 Sep 7; Authors: Dréanic J, Sion E, Dhooge M, Dousset B, Camus M, Chaussade S, Coriat R Abstract Acute diverticulitis is a common disease with increasing incidence. In most of cases, diagnosis is made at an uncomplicated stage offering a curative attempt under medical treatment and use of antibiotics. There is a risk of diverticulitis recurrence. Uncomplicated diverticulitis is opposed to complicated forms (perforation, abscess or fistula). Recent insights in the pathophysiology of diverticulitis, the natural history, and treatments have permitted to identify new treatment strategies. For example, the use of antibiotics tends to decrease; surgery is now less invasive, percutaneous drainage is preferred, peritoneal lavage is encouraged. Treatments of the diverticulitis are constantly evolving. In this review, we remind the pathophysiology and natural history, and summarize new recommendations for the medical and surgical treatment of acute diverticulitis. PMID: 26358668 [PubMed - as supplied by publisher]
Publication date: Available online 1 December 2019Source: The American Journal of SurgeryAuthor(s): Amir L. Bastawrous, I-Fan Shih, Yanli Li, Robert K. ClearyAbstractBackgroundPatients undergoing gastrointestinal surgery are at high risk for postoperative opioid use.MethodsWe evaluated inpatient opioid use among patients undergoing sigmoidectomy for diverticular disease from the Premier Hospital Database and compared across surgical approaches using propensity score-matching analysis.ResultsAfter the day of surgery, minimally invasive (MIS) patients were administered significantly lower doses of parenteral opioids (median ...
Conclusions: The finding of advanced colonic neoplasia in follow-up colonoscopy after an acute episode of CT-proven diverticulitis is equivalent to, or less than, that of the population colorectal cancer screening program. Routine colonoscopy is not necessary unless there are other concerning symptoms/CT findings.
Patients undergoing gastrointestinal surgery are at high risk for postoperative opioid use.
We present a case of a symptomatic large rectal diverticulum presenting with a retrorectal abscess. A 49-year-old Caucasian female was brought to the emergency department complaining of abdominal pain and weakness in the lower limbs. She was found to have obstructive uropathy and unilateral sciatic neuropathy. She rapidly developed acute abdomen and emergency laparotomy revealed a giant purulent rectal diverticulum. The patient underwent exploratory laparotomy and a loop colostomy was made to decompress the colon.
A 58-year-old woman with enlarging fibroid uterus in menopause presented for gynecologic evaluation. The enlarging, pedunculated, exophytic fibroid measuring 8.7 × 10 × 10 cm was noted incidentally on CT performed for an episode of acute abdominal pain attributed to diverticulitis. Three years earlier, the fibroid measured 4.0 × 4.2 × 3.9 cm on transvaginal ultrasound. Given the concern for an enlarging fibroid in menopause, MRI was perf ormed which showed a pedunculated fundal fibroid measuring 8.5 × 7.2 × 9.2 cm and progressively enhancing right ovarian cyst me...
A 76-year-old female presenting with postmenopausal bleeding and fever was admitted for suspected endometritis. Speculum exam was notable for yellow-green discharge. Endometrial biopsy showed benign endometrial glands along with feces and medication resin particles. Pelvic ultrasound revealed asymmetrical rectosigmoid wall thickening concerning for diverticulitis or malignancy (Figure 1).
PMID: 31773172 [PubMed - as supplied by publisher]
Conditions: Diverticular Disease; Diverticulitis; Diverticula Intervention: Diagnostic Test: Probe-based confocal laser endomicroscopy evaluation Sponsor: Instituto Ecuatoriano de Enfermedades Digestivas Recruiting