Complicated Diverticulitis

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.
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Resident’s Corner Source Type: research

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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.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
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.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
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.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
CONCLUSIONJejuno-ileal diverticula are a very uncommon finding that can present formidable challenges in diagnosis and treatment. The course can be completely asymptomatic, however, in rare cases, the condition can lead to severe complications that often require surgery. Multi detector CT (MDCT) with intravenous contrast should always be the modality of choice for investigating a suspect of small bowel diverticula. There are no specific guidelines respect the management of jejuno-ileal diverticulitis, nevertheless, in the acute setting, bowel resection is the treatment of choice.As well as setting out the rarity of this ca...
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionPancreatoduodenectomy is an option when complicated duodenal diverticulum is not resolved with conservative or interventional therapy.Pancreatoduodenectomy is an option when complicated duodenal diverticulum is not resolved with conservative or interventional therapy. This report has been written in concordance with the SCARE criteria Agha et al.1
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
This article provides an evidence-based, clinically relevant overview of the epidemiology, diagnosis, and treatment of acute diverticulitis. PMID: 29710265 [PubMed - in process]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
Authors: Edo-Ohonba O, Khanna R, Misra M Abstract Endogenous peritonitis resulting from inflammation or perforation of an abdominal viscus-a result, for example, of diverticulitis, cholecystitis, or acute appendicitis-can be a complication in patients undergoing peritoneal dialysis (PD), with significant morbidity and a high incidence of catheter loss.Here, we describe an end-stage renal disease patient on PD who presented with acute abdominal pain and who was diagnosed with uncomplicated PD peritonitis. His clinical course was complicated by development of eosinophilic peritonitis because of an allergy to vancomyc...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research
Conclusion We would emphasize that a definitive diagnosis by CT and MRI and appropriate antimicrobial therapy combined with surgical treatment are important for pubic osteomyelitis.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
​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...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts 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
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