Cases reported "Diverticulum"

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1/93. Intraluminal duodenal diverticulum in a child: incidental onset possibly associated with the ingestion of a foreign body.

    Funnel-type intraluminal duodenal diverticulum (windsock web) is a rare congenital malformation. A 4-year-old boy with vomiting and abdominal pain for several weeks was referred to the hospital. A plain abdominal X-ray on admission disclosed a double bubble sign. Abdominal echography and CT disclosed a foreign body lodged in the alimentary tract. After the foreign body was removed with a fibrescope, endoscopy showed a stenotic descending portion where the foreign body was located. An upper gastro-intestinal contrast study demonstrated a post-bulbar duodenal stenosis with a barium-filled pear-shaped sac in the descending portion of the duodenum. Surgical exploration was done under the diagnosis of windsock web of the duodenum. A simple excision of the web at its base was carried out. A hole 7 mm in diameter was found at the edge of the web. The microscopic appearance of the resected specimen was characterized by the duodenal mucosa with an extensive chronic inflammation lining both sides of the diverticulum and the lack of muscular layer of mucosa. CONCLUSION: If an ingested material is not excreted in the stool, possible clogging in the intestinal tract should always be considered and a further intensive examination is warranted.
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keywords = abdominal pain, upper
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2/93. Spontaneous rupture of bladder diverticula in a girl with ehlers-danlos syndrome.

    A 5-year-old girl with ehlers-danlos syndrome presented with acute abdominal pain and anuria caused by a spontaneous perforation of bladder diverticula. Conservative treatment was successful.
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ranking = 0.95354025092747
keywords = abdominal pain
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3/93. Acquired ileal diverticulum: an unusual bleeding source.

    Acquired ileal diverticulum is an uncommon condition and diagnosis is often difficult when bleeding occurs from this source. Here we describe two cases of ileal diverticulum with massive bleeding. Both patients presented with anal bleeding, but upper and lower gastrointestinal endoscopy did not reveal the source. Selective visceral angiography finally detected bleeding lesions in the terminal ileum. Surgical resection was performed in both patients, confirming that the bleeding arose from diverticula less than 1 cm in size. In patients with obscure gastrointestinal bleeding, an ileal diverticulum should be considered, and selective visceral angiography should be performed for precise diagnosis.
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ranking = 0.046459749072526
keywords = upper
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4/93. Perforation of jejunal diverticulum: case report and review of literature.

    We report the case of a 90-year-old woman, previously diagnosed with jejunal and colonic diverticula, who presented with left lower quadrant abdominal pain suggesting either colonic diverticulitis or ischemic colitis. A computed tomography scan revealed a perforated jejunal diverticulum with abscess formation. The patient promptly was treated surgically without complications. A review of the literature indicates the rarity of perforation of jejunal diverticula and the difficulty of early diagnosis. We discuss the etiology, pathogenesis, diagnosis, and management of this rare entity. It is important for primary care physicians to be familiar with this disease. Delay in work-up often results in catastrophic consequences.
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ranking = 0.95354025092747
keywords = abdominal pain
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5/93. Massive bleeding from multiple jejunal diverticula associated with an angiodysplasia: report of a case.

    We report herein the case of a 70-year-old woman who presented with massive bleeding from multiple jejunal diverticula. She was initially admitted to our hospital with massive melena. An upper gastrointestinal endoscopic examination revealed no bleeding site. colonoscopy revealed clotted and red blood throughout the colon, and a small diverticulum in the ascending colon which was thought to be the source of bleeding. Following admission, she was treated conservatively at first, but melena continued and the anemia did not improve despite blood transfusions. A laparotomy was performed and multiple jejunal diverticula, distributed from 10 to 40 cm distal to the ligament of Treitz, were found. A segment of the jejunum containing all diverticula was resected. The most distal diverticulum contained a clot of blood, but no ulceration was observed. A histological examination revealed many dilated blood vessels in the mucosa and submucosa of this diverticulum, which were compatible with the findings of angiodysplasia. Based on these findings, we believe that angiodysplasia was the cause of bleeding from the jejunal diverticula in this case.
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ranking = 0.046459749072526
keywords = upper
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6/93. Traumatic pharyngeal pseudodiverticulum in neonates and infants. Two case reports and review of the literature.

    Thirty one cases of pharyngeal pseudodiverticulum have been reported in the literature; twenty nine were diagnosed during the neonatal period. Respiratory distress, increased oral secretions, difficulty with feeding and the impossibility of passing a nasogastric catheter were the most common symptoms and/or signs. Pneumomediastinum, pneumothorax, cervical emphysema and ectopic location of a feeding catheter, alone or in combination, were identified in the chest roentgenograms of 16 patients. Esophagography and/or endoscopy were the diagnostic methods of choice. The exact location of the perforation was identified in 18 patients. Most of the perforations were in either the posterior pharyngeal wall or in the pyriform sinuses. The survival rate was as good amongst the medically treated patients as in those who underwent surgery.
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ranking = 0.028838857209394
keywords = chest
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7/93. Diverticulosis of the left ventricle.

    Nine patients, 4--60 years old, had single or multiple left ventricular outpouchings, best seen during diastole, and believed to represent congenital diverticula. The 14 diverticula, 5--28 mm long, were either along the diaphragmatic or anterior ventricular wall. Only one patient had his diverticulum surgically removed; the wall was lined by thick endocardium surrounded by normal myocardium. The lesions did not produce local or systemic complications. All patients had normal chest radiographs. The material suggests that left ventricular diverticula not associated with midline anomalies are perhaps not very rare and should be distinguished from cardiac aneurysm.
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ranking = 0.028838857209394
keywords = chest
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8/93. Superselective embolization for bleeding from duodenal diverticulum: a case report.

    Duodenal diverticulum is a well-known pathological entity. The majority of patients with this condition are asymptomatic. Although hemorrhage has been described, it is an infrequent complication. We report a patient who presented with massive upper gastrointestinal bleeding with hypovolemic shock, originating from a duodenal diverticulum. The diagnosis was made by emergency angiography. Superselective arterial embolization was performed with a successful outcome. To the best of our knowledge, superselective embolization for hemorrhage originating from a duodenal diverticulum has not previously been described in the literature.
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ranking = 0.046459749072526
keywords = upper
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9/93. Left ventricular septal aneurysm in association with bicuspid aortic valve--a case report.

    Diverticula of the left ventricle are rare cardiac anomalies. Most cases arise from the apex of the left ventricle and are usually found in children. Only a few cases have been documented in adults. The authors report a case of a 38-year-old woman who presented with dyspnea and chest pain. She was found to have a septal left ventricular diverticulum associated with bicuspid aortic valve, aortic stenosis, and aortic regurgitation. The aortic valve was replaced with the resection of the diverticulum. Pathologic examination confirmed the diagnosis of fibrous diverticulum.
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ranking = 0.028838857209394
keywords = chest
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10/93. Laparoscopic duodenal diverticulectomy.

    We report a case of successful laparoscopic resection of a diverticulum with gastrointestinal bleeding at the third portion of the duodenum. The patient was a 76-year-old man who suffered from persistent tarry stools. An upper gastrointestinal series and endoscopy revealed a large diverticulum with an ulcer and blood clots located at the lateral wall of the distal third portion of the duodenum. Under general anesthesia, a pneumoperitoneum was created by insufflating the abdominal cavity with CO2. There were dense adhesions caused by a previous open cholecystectomy. Four trocars were inserted into the peritoneal cavity for this procedure. After dissecting and identifying the duodenal diverticulum, we performed a diverticulectomy, using an Endo-GIA linear stapler at the base of the retracted diverticulum. There were no intra- or postoperative complications. The operative time was 180 min. Intraoperative bleeding was minimal. Postoperative duodenogram revealed no deformity or stenosis at the resected area. The patient was discharged after an uneventful course, and he has been doing well with no complaints during the follow-up period.
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ranking = 0.046459749072526
keywords = upper
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