Colouterine Fistula Presenting as Postmenopausal Endometritis

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).
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Images In Gynecological Surgery Source Type: research

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AbstractPurpose of ReviewSmall bowel diverticulosis is a well-known clinical entity whose diagnosis and management has evolved in recent years. This review covers pathophysiology, incidence, and prevalence, and it also provides an update on modern diagnosis and management. Meckel ’s diverticula are covered elsewhere in this volume.Recent FindingsCT scan and MRI have largely supplanted barium follow-through for diagnosis. No intervention is needed in asymptomatic individuals. Endoscopic management is playing an increasing role for both bleeding and resection of intraduodenal diverticula, but surgical intervention rema...
Source: Current Gastroenterology Reports - Category: Gastroenterology Source Type: research
Approximately 60% of adults over the age of 60 have diverticulosis, of whom 5% will experience complications such as diverticulitis or diverticular bleeding. There are an estimated 300,000 hospital admissions per year in the United States for diverticulitis (Clin Gastroenterol Hepatol 2013;11:1609-13). Despite this burden of disease, risk stratification and prevention strategies for diverticulitis are lacking. Based on the observation that diverticulitis prevalence is significantly higher in developed countries where diets are typically low in fiber, it has been hypothesized that high fiber intake is protective.
Source: Gastroenterology - Category: Gastroenterology Authors: Source Type: research
AbstractPurpose of ReviewMeckel ’s diverticulum may be detected incidentally or present with symptoms from infancy and to old age. The presentation may be acute, with several complications associated with the condition. We aim to review the many faces with which a Meckel’s diverticulum may present, either symptomatically or as an incidental finding.Recent FindingsDue to its rarity, recent studies mainly include small retrospective series or case reports. Emphasis in the recent literature is on clinical presentation, the pathology of symptomatic cases, management options and risks of neoplasia. Symptoms are main...
Source: Current Gastroenterology Reports - Category: Gastroenterology Source Type: research
Publication date: Available online 26 September 2019Source: The American Journal of SurgeryAuthor(s): Erica Pettke, Natasha DeNicola, Abhinit Shah, Vesna Cekic, Xiaohong Yan, H.M.C. Shantha Kumara, Nipa Gandhi, Richard L. WhelanAbstractBackgroundSplenic flexure mobilization (SFM) increases left colonic reach for a better vascularized and tension-free anastomosis. Open SFM is challenging due to anatomic position. Minimally invasive SFM improves visualization and minimizes splenic traction.MethodsWe retrospectively reviewed all sigmoid and low anterior resections (LAR) by a colorectal surgical group over 10-year period. We a...
Source: The American Journal of Surgery - Category: Surgery Source Type: research
ConclusionJejunoileal diverticulosis is a rare disease with life-threatening complications such as perforation, obstruction and bleeding, it is usually asymptomatic or presents with nonspecific symptoms. It should be considered in the differential diagnosis of acute abdomen
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
We reported a case of a 70-year-old female who presented to our Emergency Department (ED) with right upper quadrant pain and an initial clinical suspicion of cholecystitis. Ultrasound (US) and Computed Tomography (CT) demonstrated an anatomical variation of the sigmoid colon diverticulitis. This clinical report demonstrates that ultrasound plays a relevant part as first-step approach to the acute abdominal conditions and its accuracy increases together with other diagnostic tools such as Computer Tomography.
Source: Critical Ultrasound Journal - Category: Radiology Source Type: research
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]
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
Three-dimensional (3D) visualizations of computed tomography (CT) data have found use in the display of complex anatomy and pathology. A new method of 3D CT image creation known as cinematic rendering (CR) makes use of a global lighting model to produce photorealistic images. Cinematic rendering images contain high levels of detail with shadowing and depth that are not available from traditional 3D CT techniques. As yet, the role of CR in evaluating colonic pathology has not been investigated. However, given the breadth of pathologic processes that affect the colon, including inflammatory bowel disease, diverticulitis, neo...
Source: Journal of Computer Assisted Tomography - Category: Radiology Tags: Abdominal Imaging Source Type: research
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 ...
Source: Der Chirurg - Category: Surgery Authors: Tags: Chirurg Source Type: research
ConclusionAlthough we had no statistical evidence, a therapeutic barium enema with a standard concentration as a diagnostic examination may be effective for both the initial hemostasis and preventing the recurrence of colonic diverticular bleeding without complications.
Source: European Journal of Radiology Open - Category: Radiology Source Type: research
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