Case report: Diverticulitis complicating a giant Meckel’s divertuculum
ConclusionAlthough Meckel’s diverticulitis is a rare entity, it can appear as an acute abdomen. An early diagnosis and treatment to prevent subsequent complications is essential to ensure an optimal recovery.
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CASE SUMMARY: A 62-year-old previously healthy man presented with left lower quadrant pain and fever. Physical examination showed left lower quadrant peritonitis. Computed tomography scan showed a pelvic abscess with extraluminal air (Fig. 1). Intravenous antibiotics were started, and CT-guided percutaneous drainage was performed. The drain was removed 1 week after discharge. One week later, he presented with dysuria and pneumaturia and was started on antibiotics. Colonoscopy confirmed diverticulosis with no other mucosal abnormalities. He underwent a successful laparoscopic sigmoidectomy with colovesical fistula takedown.
Complicated diverticulitis encompasses a variety of clinical scenariors as outlined in the well-written and succinct review by Drs Mendez and Garcia-Henriquez. These range from acute presentations, such as abscesses and free perforations with peritonitis, to more chronic, insidious sequelae such as fistulas and strictures.
CONCLUSIONS: Resections that were approached laparoscopically were more likely to achieve oncologic success. Minimally invasive approaches did not lengthen operative times and provided benefits of reduced surgical site complications and decreased postoperative length of stay. Further studies are needed to clarify clinical outcomes and factors that influence the choice of approach. See Video Abstract at http://links.lww.com/DCR/B70. RESULTADOS ONCOLÓGICOS Y PERIOPERATORIOS DE LOS ABORDAJES LAPAROSCÓPICOS, ABIERTOS Y ROBÓTICOS PARA LA RESECCIÓN DEL CÁNCER RECTAL: UN ESTUDIO DE COHORTE MU...
CONCLUSIONS: Local drainage procedures maintained primary anastomosis in 50% of cases after an anastomotic leakage. See Video Abstract at http://links.lww.com/DCR/B57. ¿PUEDE UN DRENAJE LOCAL SALVAR UNA ANASTOMOSIS COLORRECTAL O COLOANAL FALLIDA? UNA COHORTE PROSPECTIVO DE 54 PACIENTES ANTECEDENTES: Los drenajes locales se pueden utilizar para controlar las fugas en pacientes seleccionados sin peritonitis. OBJETIVO: El objetivo de este estudio fue evaluar la eficacia de los procedimientos de drenaje, para mantener una anastomosis primaria baja, después de una fuga anastomótica. DISEÑO: ...
CONCLUSION: Laparoscopic surgery is associated with decreased odds of incisional hernias and adhesional intestinal obstructions compared with open surgery for colorectal cancer.
CONCLUSIONAlthough Meckel's diverticulitis is a rare entity, it can appear as an acute abdomen. An early diagnosis and treatment to prevent subsequent complications is essential to ensure an optimal recovery.
BY ALEJANDRO E. MACIAS; BILLY ZHANG; KRISTEN HUGHES; SHAMIM KHAN, MD; FRANCISCO JACOME, MDA 73-year-old man with a past medical history of hypertension, type 2 diabetes, and hyperlipidemia and a surgical history for a coronary artery bypass presented with sudden, severe lower abdominal pain. He characterized his pain as 8/10 and was tender to palpation.Laboratory studies showed a white blood cell count of 7.51 with a glucose of 759, no bands, a platelet count of 230,000, and a lactic acid level of 6.7. Urinalysis showed +5 ketones and a glucose count of greater than 500. An abdominal CT showed possible microperforations...