1/155. Perforation of acquired small bowel diverticulum. A 77-year old woman was seen with an unusual pathologic entity after emergent abdominal exploration--a ruptured small bowel diverticulum. This patient had a known previous history of colonic diverticulosis when she had acute onset of severe abdominal pain. The patient underwent an exploratory laparotomy with resection of representative segments of small and large bowel. The large bowel had evidence of diverticulosis, while the small bowel resected segment had evidence of diverticulitis with rupture. An extensive review of the literature revealed a very small number of reported cases in the world literature (less than 150 cases). We reviewed the history of reported cases of ruptured and nonruptured small bowel diverticular disease, as well as this case. ( info) |
| An unusual case of schistosomal Meckel's diverticulitis is presented. parasites were subsequently found in either stool or rectal biopsies of three siblings. The possibility of serious sequels makes the early diagnosis of schistosomiasis mansoni often by simple stool and rectal biopsy examination particularly valuable. ( info) |
3/155. Perforated jejunal diverticulitis as a rare cause of acute abdomen. Jejunal diverticula is rare and in most cases without any symptoms. They become clinically relevant when complications, such as diverticulitis, malabsorption caused by bacterial overgrowth, intestinal hemorrhage, or obstruction, occur. In this case report a case of perforated jejunal diverticulitis is presented and the problems in finding the correct diagnosis are discussed. ( info) |
4/155. Acute diverticulitis of the small bowel: CT findings. We present the computed tomographic (CT) findings in two cases of small bowel diverticulitis, one affecting the jejunum and the other a Meckel's diverticulum. The main CT finding was that of a mass with an air-fluid collection in contiguity with small bowel loops. ( info) |
5/155. Epiploic appendagitis: a new diagnosis for the emergency physician. Two case reports and a review. Two cases of epiploic appendagitis are presented. One was mistaken for acute appendicitis, the other for acute diverticulitis. In both cases, the correct diagnosis was made in the operating suite. With the aid of contemporary imaging modalities, however, the diagnosis of epiploic appendagitis need no longer hinge on the pathologic specimen but may be established by the emergency physician. As this disorder recently has been demonstrated to be predominantly self-limited, laparotomy no longer is considered necessary. Conservative management has been shown to be safe. The anatomy, pathophysiology, clinical presentation, radiologic evaluation, and emergency management of epiploic appendagitis are reviewed. ( info) |
6/155. Benign periurethral masses in women. Benign periurethral masses were encountered in 4 women. The masses included 2 vaginal leiomyomas, 1 of which was found simultaneously with a urethral diverticulum, a fibrocystic urethral mass and hyperplastic glandular tissue obstructing the bladder outlet and resembling male prostate. The physical and endoscopic features were helpful in establishing the benign nature and extent of the lesions. Although the bladder base was deformed on an excretory urographic cystogram in each case the radiographic features were non-specific except as they applied to a urethral diverticulum. Transvaginal needle biopsy is recommended in contemplation of open surgical excision. Leiomyomas are best approached transvaginally and anterior urethral masses can be reached suprapubically. ( info) |
| Two cases of inflammation of a solitary diverticulum of the caecum are reported. These probably represent the first cases to be reported in Chinese. The pathogenesis of solitary diverticulum of the caecum is different from that of multiple diverticulosis of the colon. A study of these cases was made to understand better this uncommon entity. Before operation, the symptoms, signs and physical findings of caecal diverticulitis are those found in appendicitis. The diagnosis at operation in some cases is difficult because the inflammatory reaction may simulate a malignant process. Local excision is the operation of choice. Our two patients were treated by right hemicolectomy. Discussion is presented of the clinical presentation, pathology and treatment of this condition, so that its prompt recognition may avoid the incorrect diagnosis of caecal malignancy, which in turn would lead to unnecessary radical surgery resulting in a high mortality rate. ( info) |
8/155. Intraluminal duodenal diverticulum: radiological and endoscopic ultrasonography findings of an unusual cause of acute pancreatitis. Intraluminal duodenal diverticulum is a rare congenital web of membrane which may be symptomatic when it becomes distended. This report describes a case revealed by presenting as an acute pancreatitis. The radiological findings are reported. The findings at CT, upper gastro-intestinal series, endoscopic ultrasound and endoscopic retrograde cholangiopancreatography are described and differential diagnostic features from choledochocele and duodenal duplication are discussed. By endoscopic ultrasonography, observation of a thin wall, without different layers such as choledochocele or duodenal duplication, may be useful for diagnosis. ( info) |
9/155. Xanthogranulomatous tubo-ovarian abscess resulting from chronic diverticulitis. We report a case of xanthogranulomatous tubo-ovarian abscess which was preoperatively suspected to be an adnexal neoplasm. With foreign body material found in the abscess wall and vegetable fiber in the tubal lumen, a previously treated chronic diverticulitis was the presumed cause. culture studies showed polymicrobial isolates which included escherichia coli, an enteric pathogen. After surgery, administration of antibiotics, and revision of delayed subcutaneous wound healing, the patient is reportedly well. ( info) |
10/155. Meckel's diverticulitis in an elderly man diagnosed by computed tomography. Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. Complications most frequently arise in children younger than 2 years who present with gastrointestinal bleeding. The diagnosis is usually made via radionuclide scintigraphy or intraoperatively. The authors report a 71-year-old man who developed a sudden onset of right lower quadrant abdominal pain, without bleeding, and was diagnosed as having Meckel's diverticulitis via computed tomography. The presence of Meckel' s diverticulitis was confirmed at surgery. Complications of a Meckel's diverticulum must be considered at any age. Computed tomography is another modality that may be helpful in the preoperative diagnosis. ( info) |