Endoscopy, angiography, surgery: diagnostic and therapeutic algorithms for diverticular bleeding.

[Endoscopy, angiography, surgery: diagnostic and therapeutic algorithms for diverticular bleeding]. Chirurg. 2019 Apr 11;: Authors: Schwenk W Abstract Diverticular bleeding is a complication of diverticular disease but in contrast to diverticulitis, publications concerning diverticular bleeding are less common. Diverticular bleeding is the cause of approximately 20-50% of cases of lower gastrointestinal bleeding and in rare cases can be life-threatening. The main symptom of diverticular hemorrhage is painless hematochezia and the German guidelines recommend that further diagnostics of suspected diverticular bleeding should be performed in hospital. Interdisciplinary diagnostic and therapeutic algorithms recommend primary endoscopy in acute as well as chronic recurrent diverticular bleeding. If endoscopy fails to provide an exact localization of the origin of bleeding, angiography or computed tomography (CT) angiography can be performed. The 99mTc erythrocyte scintigraphy should only be performed if endoscopy and angiography are unable to identify the localization of the bleeding source. More than 90% of diverticular hemorrhages stop spontaneously; however, it is general agreed that an active diverticular bleeding detected during colonoscopy should be immediately treated endoscopically. Alternative radiological techniques for hemostasis are rarely needed and attention must be paid to the complications. In the rare case of severe bleeding that cannot ...
Source: Der Chirurg - Category: Surgery Authors: Tags: Chirurg Source Type: research

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Publication date: Available online 13 December 2019Source: Journal of Clinical NeuroscienceAuthor(s): Wenjie Wu, Sen Yang, Wenbo Diao, Donggui Wang, Yang Guo, Ming Yan, Fei LuoAbstractAn innovative concept was proposed to treat the lumbar degenerative diseases with full-endoscopic translaminar lumbar interbody fusion (Endo-TLIF) and the efficacy was evaluated. A total of 44 patients from January 2017 to October 2018 were enrolled, including 20 patients undergoing full-endoscopic TLIF and 24 patients undergoing standard open TLIF. The Visual Analogue Scale (VAS) score, Oswestry Dability Index (ODI) and intervertebral fusion...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
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Source: Minerva Urologica e Nefrologica - Category: Urology & Nephrology Tags: Minerva Urol Nefrol Source Type: research
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Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
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Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
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Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Complicated Meckel's diverticulum represents a common etiology of acute abdomen in children. However, this condition is less frequent in adults. We reviewed the records of adult patients who underwent the surgical removal of complicated Meckel's diverticulum between 2001 and 2017 at 2 tertiary French medical centers. We then analyzed the clinical characteristics, mode of presentation, and management for all patients. The Meckel's diverticulum was resected in 37 patients (24 males and 13 females). The mean patient age was 46.1 ± 21.4 years. The most common clinical presentations of complicated Meckel's diverticu...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
By ANISH KOKA, MD A poignant piece recently appeared in the journal Health Affairs and was rapidly devoured on social media by the health policy community. The story is a harrowing first person account of a woman’s multiple interactions with doctors. The doctors in the story are either very good or very bad. One pediatrician turns the author and her sick son away on three consecutive days with colic, only to have a more careful partner sound the alarm and discover pyloric stenosis. The author then recounts the tale of her father’s death at age 42 due to a surgeon who operated for diverticulitis unnecessarily. ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs
A 64-year-old woman presented to the colorectal clinic with 3 months of symptoms of loose stools, flatulence and some weight loss. There was no history of abdominal pain, rectal bleeding or anaemia. A similar episode 5 years earlier resolved spontaneously but was investigated with a colonoscopy at that time and revealed diverticular disease and a 3 mm hyperplastic polyp at the hepatic flexure. To investigate the current symptoms, a repeat colonoscopy was advised but this was initially declined in favour of CT colonography (CTC) to avoid the laxative preparation and pain experienced during the previous examin...
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Snapshot Editor ' s quiz: GI snapshot Source Type: research
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Source: Journal of the American Academy of Physician Assistants - Category: Primary Care Tags: Case Report Source Type: research
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Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
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