A case of solitary rectal diverticulum presenting with a large retrorectal abscess
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.
Publication date: Available online 12 September 2019Source: Surgery (Oxford)Author(s): Rishabh Singh, Andrea ScalaAbstractUse of minimally invasive approaches to acute abdominal surgical emergencies has increased in recent decades. Uptake has been slower than for elective surgery, however, with concerns regarding inadvertent injury and operative time being most frequently cited. Laparoscopy for abdominal pain has shown to be safe and is a useful diagnostic procedure in the context of unexplained abdominal pain. Minimally invasive surgery has also been shown to be the approach of choice in appendicitis and cholecystitis. La...
ConclusionThe diagnosis of severe acute UC in elderly patients with acute abdomen had been complicated by the distinctive physiology of this aged group with atypical presentation and markedly unreliable physical examination. Eventually, severe UC should always be kept in mind with a circumstance of abdominal pain in geriatric population.
CONCLUSIONS: With this report we want to discuss about different therapeutic approaches for perforated jejuno-ileal diverticula, which depends on the severity of the disease and the general clinical condition of the patient. KEY WORDS: Acute abdomen, Surgery, Jejunal Diverticulitis. PMID: 31112519 [PubMed - in process]
Conclusions: SILS equals open sigmoidectomy regarding complications with advantages regarding pain, LoS, IMC/intensive care unit treatment, and blood transfusion.Dig Surg
ConclusionsMassive mediastinal and retroperitoneum emphysema are rare signs of colonic perforation. Emergency laparotomy should be considered in colonic penetration of the diverticulitis where the emphysema expands to the mediastinum extensively.
A 42-year-old man presented to the emergency room with complaints of periumbilical abdominal pain. A contrast-enhanced computed tomography revealed mucosal thickening in the small bowel of the right abdomen. There was a fairly large small bowel diverticulum associated with this segment. Findings were suggestive of small bowel diverticulitis or possibly focal enteritis. A Meckel ’s diverticulum scan was diagnostic of Meckel’s diverticulum. The patient was then immediately taken to the operating room for emergency laparotomy and was intra-operatively found to have a thickened Meckel’s diverticulitis with ad...
CONCLUSIONS: Diagnosis of SBNMD is often made at emergency surgical exploration with high morbidity and mortality rate. SBNMD must be considered in elderly patients presenting with abdominal pain. Multidisciplinary approach to patient (radiologist, surgeon, gastroenterologist) is necessary to make early diagnosis. In case of complicated SBNMD, emergency surgeon has to choose the right surgical treatment, if necessary. PMID: 29795067 [PubMed - as supplied by publisher]
We report a 9-year-old boy who presented with acute onset of periumbilical pain and nonbilious vomiting. His clinical and laboratory parameters were unremarkable, except for serum amylase levels. He was conservatively managed initially as acute pancreatitis with paralytic ileus. However, the child deteriorated in a course of 2 days with bilious vomiting, abdominal distension, and dehydration. Imaging was suggestive of an ileoileal intussusception, and exploratory laparotomy identified Meckel's diverticulum as the lead point for the intussusception. The histopathological examination revealed inflamed heterotopic pancrea...
A 75 year old patient presented (3 years after left nephroureterectomy) with acute abdominal pain and left lower abdomen tenderness. Emergency computed tomography angiography revealed left common iliac artery rupture with contrast outflow in the sigmoid colon (A). Urgent laparotomy with resection of the sigmoid colon and left common iliac artery followed. The former was resected, both ends stapled, and left blind. (B) The latter was replaced with a bovine pericardium tube (Peri-Guard; Synovis, Birmingham, AL, USA) and wrapped with omentum.
Conclusion Perforation from JD is exceedingly rare. Due to their infrequent clinical significance, complications from JD are difficult to diagnose and therapeutic options are typically made intraoperatively. Any deviation from the expected positive pathway in the management of a suspected entity should prompt an immediate reassessment as well as definitive therapeutic options.