We present a rare occurrence of a perforated diverticulum of the sigmoid colon found within the contents of a strangulated left inguinal hernia in a 75-year-old man. The hernia was repaired using the Bassini technique. [ncbi.nlm.nih.gov]

Methods and Results: A fifty year old male previously healthy, presented with sudden severe epigastric pain of few hours duration. He had history of Helicobacter pylori three years prior to his presentation but he declined treatment and endoscopy. [sages.org]

Minimal pus was present intraoperatively in the paracolic gutters. [saudijgastro.com]

• Pathologist

  Emergency procedures have to be performed for cases with perforated MD and the pathologists may be often absent for frozen section of the specimen to assess the gastric mucosa of the presence of malignancy. [medsci.org]

  We thank Dr Lalit Lad, Consultant Pathologist, Nagpur for providing us the histopathology slides of this patient. 1. Shyung LR, Lin SC, Shih SC, Kao CR, Chou SY. Decision making in right sided diverticulitis. [saudijgastro.com]

  All slides from 38 appendices were subsequently reviewed by at least two pathologists. [nature.com]

  Pierre Jean Baptiste Chomel, 1 a French pathologist, provided the first description of a duodenal diverticulum in 1710. The prevalence has been found to be as high as 22% in autopsy series, but most cases are asymptomatic. [jamanetwork.com]

• Dyspnea

  We describe the case of a 58-year-old man who presented to the hospital with central abdominal pain, nausea, fever, chills, and dyspnea. [ncbi.nlm.nih.gov]

  A previously unreported cause of suppurative pylephlebitis and multiple hepatic abscesses Summary We describe the case of a 58-year-old man who presented to the hospital with central abdominal pain, nausea, fever, chills, and dyspnea. [link.springer.com]

• Epigastric Tenderness

  On examination, he demonstrated epigastric tenderness without peritoneal signs. [jamanetwork.com]

• Palpitations

  This edition's highlights include new chapters on palpitations, cystic fibrosis, travel related emergencies, and ultrasound and a new appendix on practice pathways. [books.google.com]

• Withdrawn

  When the endoscope was withdrawn, a sigmoid diverticulum with a ragged lining was noted to be bleeding — a finding that suggested possible perforation. [nejm.org]

Diagnostic workup is usually completed in the intensive care setting. Most patients stop bleeding, allowing elective surgery. Mesenteric angiography with infusion of vasoconstrictors can be used in persistent hemorrhage. [emedicine.medscape.com]

Results of the workup revealed a possible duodenal perforation, and the patient was transferred to our institution for continued care. On arrival, the patient complained of mild abdominal discomfort. She was afebrile. [jamanetwork.com]

Miehlke: In my opinion, a sigmoidoscopy also has no place in the primary diagnostic workup of acute diverticulitis, for the same reasons already mentioned. [karger.com]

Early diagnosis is essential for successful treatment. To our knowledge, this is the first report of laparoscopic resection of a perforated duodenal diverticulum. [sages.org]

In general, the surgical approach was considered the treatment of choice. [synapse.koreamed.org]

Surgical treatment of Meckel's diverticulum. South Med J. 1993; 86 (6):671-675 9. Lu CC, Huang FC, Lee SY. Laparoscopy diagnosis and treatment excision of bleeding Meckel's diverticulum in a child: report of one case. [medsci.org]

Early surgical intervention is the treatment of choice but in selected patients non-operative management may be required. [casereports.in]

In the case of deterioration or diagnostic uncertainty, operative treatment must be used. [jamanetwork.com]

The prognosis varies if complications develop and is particularly serious in the case of peritonitis. About 90% of people who have a colon resection do not have symptoms return after the surgery. [drugs.com]

What should you tell the family about the patient's prognosis? In general, the prognosis after an episode of uncomplicated diverticulitis is good. [infectiousdiseaseadvisor.com]

[…] antibiotics, low-fiber foods; for severe diverticulitis with high fever and pain, hospitalization, IV antibiotics Management-surgical Excision of bleeding diverticula or resection for persistent bowel obstruction or abscesses not responding to antibiotics Prognosis [medical-dictionary.thefreedictionary.com]

The prognosis in patients with diverticulitis depends on the severity of the illness, the presence of complications, and the presence of any coexisting medical problems. [emedicine.medscape.com]

Prognosis Approximately three quarters of patients with anatomical diverticulosis remain asymptomatic. Most complications of diverticulitis are associated with the initial attack, after which the disease tends to run a benign course. [patient.info]

Etiological factors leading to diverticular perforation after coronary artery bypass grafting are discussed. The significance of pneumoperitoneum on the postoperative chest radiograph, which prompted diagnosis in these cases, is also discussed. [ncbi.nlm.nih.gov]

Etiology Caused mainly by lifestyle and environmental factors Increasing age Genetic factors Diet ( low-fiber, rich in fat and red meat) Obesity, low physical activity Cigarette consumption References: [2] [3] Classification Pathophysiology Diverticulosis [amboss.com]

In cases of complicated diverticular disease, where a colonic fistula is present, a colonoscopy can confirm the site and etiology of the fistula. [clevelandclinicmeded.com]

The etiology and pathophysiology of diverticulitis is not fully understood and may vary among patients. [merckmanuals.com]

This review appraises existing evidence on the epidemiology and mechanisms of perforation, highlights areas of further study, and suggests an epidemiological approach towards preventing the condition. [pmj.bmj.com]

[1] [2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Back to Top Incidence and Epidemiology The incidence of diverticulosis in the Western world has progressively increased over the past century. [clevelandclinicmeded.com]

Diverticular disease as a chronic illness: evolving epidemiologic and clinical insights. Am J Gastroenterol. 2012 Oct. 107 (10):1486-93. [Medline]. Brandl A, Kratzer T, Kafka-Ritsch R, Braunwarth E, et al. [emedicine.medscape.com]

An epidemiologic, population-based study. Ann Surg. 1994;220(4):564-8. [ Links ] 4. Satya R, O'Malley JP. Case 86: Meckel diverticulum with massive bleeding. Radiology. 2005;236(3):836-40. [ Links ] 5. Tauro LF, Martis JJ, Menezes LT, Shenoy HD. [scielo.org.pe]

Inflammation of the diverticulum may be due to obstruction of the lumen, which is analogous to the pathophysiology of acute appendicitis. Progression of such inflammation may lead to perforation and peritonitis. [emedicine.medscape.com]

Etiology Caused mainly by lifestyle and environmental factors Increasing age Genetic factors Diet ( low-fiber, rich in fat and red meat) Obesity, low physical activity Cigarette consumption References: [2] [3] Classification Pathophysiology Diverticulosis [amboss.com]

Although it generally remains silent but life threatening complications may arise making it an important structure for having a detailed knowledge of its anatomical and pathophysiological properties to deal with such complications. [wjes.biomedcentral.com]

Less is known regarding the pathophysiology behind diverticular inflammation and development of diverticulitis. [clinicaladvisor.com]

Pathophysiology In an aging bowel that has naturally become weakened in certain areas over time, the movement of stool within the lumen will cause an increase in luminal pressure. [teachmesurgery.com]

Diet high in fiber increases stool bulk and prevents constipation, and theoretically may help prevent further diverticular formation or worsening of the diverticular condition. [medical-dictionary.thefreedictionary.com]

Can Diverticular Disease Be Prevented? Diverticula are permanent once formed and can only be removed surgically. There is currently no treatment to prevent diverticular disease. [onhealth.com]

How Can Diverticulosis Be Prevented? To prevent diverticular disease or reduce the complications from it, maintain good bowel habits. Have regular bowel movements and avoid constipation and straining. [webmd.com]

Morbidity has traditionally been reported to be worse in younger patients, but this has not been shown to be true. [ 9 ] Prevention [ 2 ] Dietary fibre may prevent development of diverticular disease but, once symptoms develop, the benefit from fibre [patient.info]

Lots of patients ask, “How do I prevent myself from getting diverticulitis?” Unfortunately, we don’t know why people get it. We think it’s from high pressure in the bowels and being constipated. [health.clevelandclinic.org]