Cases reported "Diverticulum, Stomach"

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1/24. Laparoscopic resection of gastric diverticulum.

    Gastric diverticulum is a rare disorder. The laparoscopic approach may be ideal for the resection of gastric diverticulum in some cases. The authors believe this to be the first reported case of gastric diverticulum resected laparoscopically. A 59-year-old woman was admitted with indigestion and epigastric pain. Upper gastrointestinal series showed a single diverticulum (3 x 2 cm) on the posterior wall of the upper part of the stomach. The neck of the diverticulum was relatively narrow. Gastroduodenoscopy revealed that food residues were impacted within the diverticular pouch. Other areas of the stomach and the duodenum were normal. Abdominal ultrasonography showed no other pathologic conditions in the upper part of abdomen. On operation, the lesser sac was entered by division of the greater omentum along the avascular plane of the transverse colonic attachment. The location of the diverticulum was confirmed by intraoperative gastroscopy. Using a 5-cannula techniques, the diverticulum was resected with an endoscopic linear stapler device. Pathologic examination of the resected specimen demonstrated chronic superficial gastritis. Flatus was passed out on the first postoperative day, diet was started from the second day, and the patient was discharged on the fifth day without problems. ( info)

2/24. Laparoscopic management of gastric diverticula.

    Gastric diverticular are rare and usually are diagnosed incidentally on radiographic examination. Surgical treatment, consisting of simple excision or inversion of the diverticulum, has been reserved for patients with proven symptoms or complications. These procedures have typically required laparotomy, but with the development of advanced endoscopic techniques, a minimally invasive approach may be appropriate. The authors report two cases of gastric diverticula managed laparoscopically and review the literature related to this entity. Between 1993 and 1996, two patients were evaluated for dyspepsia-like gastrointestinal complaints. Both patients were found to have a gastric diverticulum on a contrast study, and one diverticulum was also seen on upper endoscopy. Laparoscopic resection was undertaken in both cases. Flexible gastroscopy was performed intraoperatively to help localize the diverticulum, which was resected with an endoscopic stapling device. Nissen fundoplication was performed in conjunction with the diverticulectomy in the second patient for gastroesophageal reflux. Both procedures were completed laparoscopically without complications. The postoperative course was uneventful in both patients. At long-term follow-up, the patients are asymptomatic. This experience indicates that laparoscopic resection of symptomatic gastric diverticula is a feasible alternative to laparotomy. A prospective analysis to verify the safety and efficacy of this procedure should be done. ( info)

3/24. Caroli's disease associated with a gastric diverticulum.

    Caroli's disease or communicating ectasia of the intrahepatic biliary tree is a rare disease with unknown aetiology. The coexistence of this along with the uncommon condition of a gastric diverticulum has never been reported before. A deficiency in the fibromuscular matrix of both the bile ducts and the gastric wall may explain why these two pathologies may coexist in a single patient. ( info)

4/24. Proximal gastric diverticulum after anterior lesser curve seromyotomy.

    A case of gastric diverticulum arising in a patient who had previously undergone anterior lesser curve seromyotomy for chronic duodenal ulcer disease is reported. The endoscopic appearance of this lesion is described and the potential mechanisms of causation are reviewed. The clinical relevance of this rare finding is examined with emphasis on the need for an index of awareness of this abnormality on the part of endoscopists and in particular, on the risks of injudicious biopsy of such a diverticulum. ( info)

5/24. Laparoscopic management of a gastric diverticulum.

    Gastric diverticuli are rare entities that may present with a variety of vague abdominal symptoms. diagnosis requires endoscopic and radiologic evaluation preceded by clinical suspicion. This is the first report describing the laparascopic excision of a gastric diverticulum. A description of this procedure and suggestions for the workup of gastric diverticuli are presented. ( info)

6/24. Late presentation of a congenital gastric diverticulum causing pyloric obstruction.

    We report a case of adult pyloric obstruction caused by the delayed presentation of a congenital gastric diverticulum. The derivation, classification and treatment of these abnormalities are discussed. ( info)

7/24. Laparoscopic resection of a gastric diverticulum: a case report.

    A 30-year-old woman presented with halitosis, sour taste, bloating, and right-sided abdominal pain of 3-months' duration. An upper gastrointestinal series revealed a diverticulum in the posterior cardia of the stomach. The patient underwent a laparoscopic resection of the diverticulum. Postoperatively, the patient did well; at a 28-month follow-up, no further symptoms were reported. Laparoscopic removal of a diverticulum produced an excellent outcome. ( info)

8/24. Gastric diverticulum preoperatively diagnosed as one of two left adrenal adenomas.

    A 47-year-old man was diagnosed with primary aldosteronism due to two left adrenal adenomas, suggested on computed tomography (CT) to be located at the upper and lower adrenal portion. However, adosterol scintigraphy revealed negligible uptake at the upper portion of the left adrenal. Laparoscopic left adrenalectomy was performed, but macroscopic examination of the specimen revealed only one adrenal tumor. Continued surgical exploration detected another mass between the spleen and the stomach, which was demonstrated to be continuous with the stomach and was eventually diagnosed as a gastric diverticulum. Postoperatively, aldosteronism resolved and repeat CT revealed staining of the adrenal pseudotumor when oral contrast was administered. Since organs located near the adrenals can simulate adrenal tumors, caution must be exercised in interpreting suprarenal masses on CT. To our knowledge, this is the first reported case of concurrent pseudotumor and true tumor of the ipsilateral adrenal. ( info)

9/24. Laparoscopic gastric diverticulectomy in a 13-year-old girl.

    Symptomatic gastric diverticula are rare, mainly occurring in patients between 20 and 60 years of age. In adults, laparoscopic resection seems to be an attractive alternative to conventional surgery, although some authors experienced problems in identifying the diverticulum intraoperatively. We present a case of a gastric diverticulum in a 13-year-old girl and emphasize the difficulties in establishing the diagnosis. Once other gastrointestinal disorders were excluded, a laparoscopy was performed and the diverticulum resected successfully with an endoscopic linear stapler device. This is the first report on laparoscopic resection of a gastric diverticulum in a child. More experience is mandatory to confirm the safety and long-term success of a minimal invasive technique for this pathologic entity in pediatric patients. ( info)

10/24. Surgical treatment of a gastric diverticulum in an adolescent.

    Gastric diverticula are uncommonly seen in childhood. They typically emanate from the posterior wall of the stomach near the gastroesophageal junction. The authors report on a 15-year-old adolescent boy who presented with a symptomatic gastric diverticulum that was surgically resected. Potential pitfalls in diagnosis and treatment are discussed. ( info)
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