Cases reported "Diverticulitis"

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21/37. Caecal diverticulitis.

    Ten cases of caecal diverticulitis are reviewed. Caecal diverticulitis is frequently diagnosed as appendicitis pre-operatively and is difficult to distinguish from carcinoma or inflammatory bowel disease intra-operatively. The average age of presentation is younger than that of left-sided colonic diverticulitis. Most of the diverticula are narrow-neck false diverticula. When diagnosed intra-operatively hemicolectomy can often be avoided.
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22/37. Enterolithiasis.

    We have seen two cases of enterolithiasis in middle-aged Bedouin women. In the first, the cause was prestenotic saccular dilatation from a postoperative stricture of the terminal ileum. In the second, stones formed in congenital diverticula in the terminal ileum and cecum. In both patients, the diagnosis was established by small-bowel enema.
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23/37. Small-bowel diverticulitis: CT findings.

    Three patients with subsequently proven small-bowel diverticulitis were studied with preoperative CT. In all three cases, an inflammatory mass was present, two involving the terminal ileum and cecum and one involving the jejunum. While the findings in the two cases of ileal diverticulitis simulated appendicitis, in the case of jejunal diverticulitis the diagnosis was suggested on the basis of CT findings. Small-bowel diverticulitis should be included in the differential diagnosis if an inflammatory mass involving the small bowel is demonstrated on CT.
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24/37. Management of cecal diverticulitis.

    A case of solitary cecal diverticulum is presented. Acute inflammation of a solitary diverticulum in the cecum appears rare. Preoperative diagnosis is difficult, and the disease is frequently confused with appendicitis or carcinoma. Right colectomy is a safe effective therapy in patients with this condition.
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25/37. Solitary diverticulum of the caecum and its complications.

    Solitary diverticulum of the caecum is very rare and assumes clinical interest only when inflamed. Preoperatively the condition is virtually impossible to distinguish from acute appendicitis, and even during operation its differentiation from carcinoma is difficult. It is also important to determine whether or not an underlying solitary diverticulum of the caecum is present. In the present series the symptoms and clinical examination as well as laboratory findings pointed to acute appendicitis, which was in fact the preoperative diagnosis in all our patients. In one case the operative findings were strongly suggestive of carcinoma, which was only excluded by inspection and histological examination of the specimen. The wall of the diverticulum was necrotic in all cases. It had already perforated in the previously mentioned case, and right hemicolectomy was performed. An inflamed, but recognizable, solitary diverticulum of the caecum was treated by excision, but the tumour-like mass produced by the diverticulum was removed by resection. In view of the considerable possibility of underlying carcinoma, the authors support an aggressive trend in the treatment of "inflammatory tumours" of the caecal wall.
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26/37. Hepatic abscesses in diverticulitis.

    liver abscess is an uncommon but potentially lethal complication of diverticulitis. Either may be present in an occult form. We present two cases to illustrate the diagnostic and therapeutic problems created by these occult presentations. A high index of suspicion and an aggressive diagnostic approach are necessary to ensure early diagnosis and proper treatment. barium enema should be done in patients with liver abscesses when there is no obvious source for the abscess. Intraoperative evaluation of the liver, including needle aspiration of any suggestive areas, should be done in all patients operated upon for complicated diverticulitis. patients with diverticulitis and abnormal results of liver function tests should have liver scan or abdominal sonography.
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27/37. Colovesical fistula due to sigmoid colon diverticulitis: a case report.

    We present a case of colovesical fistula due to sigmoid colon diverticulitis. A 63-year-old woman was referred to our department with the complaints of dysuria, turbid and foul smelling urine. She was treated twice for acute cystitis at the referral hospitals. A diagnosis of colovesical fistula was confirmed on barium enema. She underwent partial resection of sigmoid colon with primary anastomosis and partial cystectomy with repair of bladder wall and covered with omentum. Retrograde cytography taken on the 20th post-operative day revealed no leakage of contrast medium. She was asymptomatic at 3 months of follow-up.
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28/37. Partial small bowel obstruction secondary to ileal diverticulitis.

    A case of distal ileal diverticulosis complicated by diverticulitis causing partial small bowel obstruction is presented. To the author's knowledge, this is the first reported case of such obstruction, and the third reported case of preoperatively diagnosed ileal diverticulitis. This diagnosis should be considered in patients with acute abdominal symptoms and/or small bowel obstruction.
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29/37. Inflamed duodenal diverticulum. Preoperative radiographic diagnosis.

    The sixth reported case of duodenal diverticulitis diagnosed preoperatively is presented. A review of the literature indicates that most duodenal diverticula are asymptomatic and require little special management. Rarely, acute inflammation can develop, and duodenal diverticulitis must be included in the differential diagnosis of all acute upper abdominal conditions, especially in the radiographic differential of emphysematous cholecystitis and retroperitoneal emphysema.
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30/37. Laparoscopic-directed small bowel resection for jejunal diverticulitis with perforation.

    The authors report a case in which an 87-year-old woman underwent diagnostic laparoscopy for abdominal pain of unknown etiology. Jejunal diverticulosis was discovered with diverticulitis and perforation into the mesentery. Visualization of the appendix, ovaries, uterus, colon, and liver ruled out additional pathology. The disease was serious enough that resection of the involved jejunum was necessary. With the aid of the laparoscope, the incision was directed nearer to the area of the disease. A 5 cm left upper quadrant transverse incision was made, allowing removal of perforation and the diseased bowel. Primary resection and anastomosis were performed. This case sets a precedence for use of exploratory diagnostic laparoscopy and particularly small bowel resection for symptomatic diverticulitis. The authors believe that this technique results in less postoperative pain, allowing for a prompt recovery with minimal morbidity and mortality, particularly in the elderly population.
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