Search Our Scientific Publications & Authors

Eur J Radiol 2021 Jun 6;141:109813. Epub 2021 Jun 6.

Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Center for Radiology and Endoscopy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. Electronic address:

Purpose: We evaluated the accuracy of preoperative CT in staging colonic diverticulitis (ACD) by using the classification of diverticular disease (CDD) and investigated the diagnostic impact of water enema (WE) and visceral obesity.

Methods: In this retrospective study, the radiological and hospital information system was searched for patients who underwent CT for clinically suspected ACD prior to surgery between 2009 and 2019. From the initial population (n = 164), we included 155 patients (94. Read More

Surg Endosc 2021 Jun 10. Epub 2021 Jun 10.

Dept. General Surgery, Caboolture Hospital, 97/120 McKean Street, Caboolture, QLD, 4510, Australia.

Background: The incidence of colonic diverticulitis is increasing. In Australia the majority of diverticulitis occurs in the left colon and patients typically undergo colonoscopy following an attack. At present debate exists regarding the utility of this costly procedure and a flexible sigmoidoscopy has been proposed as a cheaper, less invasive alternative. Read More

Cureus 2021 May 8;13(5):e14900. Epub 2021 May 8.

Internal Medicine, Detroit Medical Center Sinai-Grace Hospital, Detroit, USA.

Colonic perforation is associated with high mortality rates, and it requires prompt diagnosis and intervention to ensure favorable patient outcomes. The condition usually presents with typical peritoneal signs and symptoms, but atypical presentations can be a diagnostic challenge. In this report, we present a case of sigmoid diverticulosis perforation in an elderly patient who had no symptoms after the perforation developed. Read More

Dis Colon Rectum 2021 Jun 8. Epub 2021 Jun 8.

Division of General Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah.

Case Summary: A 46-year-old male with no significant past medical or surgical history presented to the emergency department with a 1-week history of worsening constipation, abdominal distension, nausea, and non-bloody, non-bilious emesis. Workup included a computed tomography (CT) scan which was notable for a 5.3 x 3. Read More

Tech Coloproctol 2021 Jun 8. Epub 2021 Jun 8.

Division of Colon and Rectal Surgery, University of Illinois at Chicago, 840 S. Wood St., Suite 518E CSB (MC 958), Chicago, USA.

Background: The surgical treatment of rectovaginal fistula (RVF) remains challenging and there is a lack of data to demonstrate the best, single procedure. The aim of this study was to assess the results of different surgical operations for rectovaginal fistula.

Methods: Patients with RVF who underwent surgical repair between 1992 and 2017 at a single, tertiary care center were included. Read More

Chirurg 2021 Jun 7. Epub 2021 Jun 7.

Klinik und Poliklinik für Allgemein‑, Viszeral‑, Transplantations‑, Gefäß- und Kinderchirurgie, Zentrum Operative Medizin, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.

Background: The correct medical indications are the fundamental decision process for the surgical treatment and ensuring the quality.

Objective: Description of the indications for surgical treatment of the various types of diverticular disease according to the current level of evidence.

Material And Methods: The narrative review is based on current national and international guidelines and a selective literature search. Read More

Int J Colorectal Dis 2021 Jun 4. Epub 2021 Jun 4.

Department of Digestive Surgery, Rouen University Hospital, 76000, Rouen Cedex, France.

Background: Surgical management of Hinchey III and IV diverticulitis involves Hartmann's procedure (HP) or primary resection anastomosis (PRA) with or without fecal diversion. These procedures were evaluated in four randomized controlled trials. Early results from these trials demonstrated similar rates of complications but higher rates of colonic restoration after PRA than HP. Read More

ANZ J Surg 2021 May 31. Epub 2021 May 31.

Department of Colon and Rectal Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Background: The aim of this study was to analyze the evidence regarding open versus laparoscopic surgery for the treatment of diverticular colovesical fistula (CVF) in terms of perioperative outcomes.

Methods: A systematic review was performed using PubMed, Cochrane, Google Scholar, and Web of Science databases for studies comparing laparoscopic versus open surgery for CVF. We pooled odds ratios (OR) and mean differences (MD) using random or fixed effects models. Read More

J Minim Access Surg 2021 May 1. Epub 2021 May 1.

Department of Surgical, General and Laparoscopic Surgery Unit, Lilavati Hospital and Research Center, Mumbai, India.

Aim: Diverticular disease is widespread worldwide. Mainstay approach is non-operative treatment with bowel rest and broad-spectrum intravenous antibiotics. However, extra-colic abscess larger than 4 cm may require percutaneous trans-abdominal drainage. Read More

Medicine (Baltimore) 2021 May;100(21):e26085

Department of General and Gastroenterological Surgery.

Rationale: As the world's population ages, the number of surgical cases of colovesical fistulas secondary to colon diverticulitis is also expected to increase. The key issue while performing laparoscopic surgery for these fistulas is the avoidance of iatrogenic ureteral injury. There are no reports of Near-infrared Ray Catheter being used in surgery for diverticulitis, which is one of the diseases with the highest risk of ureteral injury. Read More

AJR Am J Roentgenol 2021 May 12. Epub 2021 May 12.

Department of Radiology, NYU Langone - Long Island Hospital, 259 First Street, Mineola, NY 11501.

Acta Biomed 2021 04 30;92(S1):e2021154. Epub 2021 Apr 30.

Emergency Surgery Unit, Parma University Hospital.

We report a peculiar case of jejunal diverticulitis in 54-year-old female. Since hospital admission, a colonic diverticulitis was suspected. CT scan of the abdomen showed multiple fluid collections with free intraperitoneal extraluminal air, suggesting bowel perforation. Read More

Clin Imaging 2021 Apr 29;79:133-135. Epub 2021 Apr 29.

2160 S 1st Ave, Maywood, IL 60153, Department of Radiology c/o Linda Schomer, United States of America. Electronic address:

Colonoscopy is the most sensitive and specific test for detecting colon cancer and is a common procedure performed in over 19 million people annually in the United States as of 2017. Though the incidence of complications from colonoscopy is low, there are several important complications that may require surgical intervention including bowel perforation, bleeding, splenic injury, and diverticulitis. Post-polypectomy coagulation syndrome (PPCS) is an uncommon complication of colonoscopy however, clinical presentation mimics bowel perforation and the differentiation between the two is vital as the management differs. Read More

Scand J Surg 2021 May 3:14574969211011032. Epub 2021 May 3.

Department of Abdominal Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland.

Left-sided colonic diverticulitis is a common condition with significant morbidity and health care costs in Western countries. Acute uncomplicated diverticulitis which is characterized by the absence of organ dysfunction, abscesses, fistula, or perforations accounts for around 80% of the cases. In the last decades, several traditional paradigms in the management of acute uncomplicated diverticulitis have been replaced by evidence-based routines. Read More

Nutrients 2021 Apr 14;13(4). Epub 2021 Apr 14.

Medical-Surgical Department of Clinical Sciences and Translational Medicine, University Sapienza, 00189 Rome, Italy.

Recent evidence showed that dietary habits play a role as risk factors for the development of diverticular complications. This systematic review aims to assess the effect of dietary habits in the prevention of diverticula complications (i.e. Read More

Eur J Radiol Open 2021 31;8:100341. Epub 2021 Mar 31.

Department of Radiology and Nuclear Medicine, Oslo University Hospital Ullevål, Oslo, Norway.

Background: Following an episode of acute diverticulitis, surgical guidelines commonly advise routine colonic follow-up to rule out underlying malignancy. However, as a CT of the abdomen is frequently performed during clinical work-up, the routine need for colonic follow-up has become debated.

Purpose: To evaluate the need for routine CT colonography after an episode of CT-verified uncomplicated sigmoid diverticulitis to rule out underlying colorectal malignancy. Read More

Chirurg 2021 Apr 22. Epub 2021 Apr 22.

Klinik für Radiologie, Städtisches Klinikum St. Georg Leipzig, Delitzscher Str. 141, 04129, Leipzig, Deutschland.

Background: Diverticular disease frequently leads to emergency admissions. Clinical parameters are not sufficiently accurate to determine the extent of acute colonic diverticulitis, thus a quick, reproducible and valid diagnostic imaging procedure is required.

Objective: In the following, the imaging methods commonly used for the diagnostic work-up and staging of diverticulitis are presented and classified in the context of the data situation and clinical reality. Read More

Case Rep Gastrointest Med 2021 1;2021:5543505. Epub 2021 Apr 1.

Department of Surgery, Evaggelismos General Hospital, Athens, Greece.

Fistulae between the colon or the small intestine and the uterus are extremely rare as the uterus is a thick, muscular organ. Here, we present the case of a 74-year-old female presenting to our surgical department because of fecal vaginal discharge for the past few months, which proved to be caused by a combined colouterine and jejunouterine fistula due to chronic diverticulitis. Total abdominal hysterectomy with bilateral oophorectomy with en bloc resection of part of the jejunum and the sigmoid colon and primary anastomoses were performed. Read More

Chirurg 2021 Apr 14. Epub 2021 Apr 14.

Medizinische Fakultät, Universität Köln, Köln, Deutschland.

Diverticula of the colon are very common and usually asymptomatic but 20% of people with diverticulosis develop symptoms and sometimes also complications, such as diverticulitis with abscesses or perforation and bleeding. In the long-term stenoses or a conglomerate can occur. The treatment depends on the type of diverticular disease, on the knowledge of risk indicators and imaging with sonography or computed tomography (CT). Read More

Ann R Coll Surg Engl 2021 Apr 14. Epub 2021 Apr 14.

Cambridge University Hospitals NHS Foundation Trust, UK.

Introduction: Diverticular disease is one of the most frequent reasons for attending emergency departments and surgical causes of hospital admission. In the past decade, many surgical and gastroenterological societies have published guidelines for the management of diverticular disease. The aim of the present study was to appraise the methodological quality of these guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II) tool. Read More

AJR Am J Roentgenol 2021 Apr 7. Epub 2021 Apr 7.

Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.

Adoption of low-dose CT for the diagnosis of appendicitis has been slow in children and in adults, partly due to the concern of missed alternative diagnoses including right colonic diverticulitis. To retrospectively compare the diagnostic performance between IV contrast-enhanced 2-mSv and conventional-dose CT (CDCT) for the diagnosis of right colonic diverticulitis in adolescents and young adults with suspected appendicitis. This post-hoc analysis of a prospective randomized controlled trial included 3074 patients ranging 15-44 years old (28 ± 9 years; 1672 women, 1402 men) from 20 hospitals, randomized into 2-mSv (n = 1535) or CDCT (median, 7 mSv; n = 1539) groups from December 2013 to August 2016. Read More

Medicina (Kaunas) 2021 Mar 23;57(3). Epub 2021 Mar 23.

Department of Surgery "Pietro Valdoni", Sapienza, University of Rome, 00161 Rome, Italy.

: The incidence of diverticulitis is increasing in western countries. Complicated diverticulitis is defined as diverticulitis associated with localized or generalized perforation, localized or distant abscess, fistula, stricture or obstruction. Colonic symptomatic strictures are often treated with segmental colectomy. Read More

Dig Dis Sci 2021 Mar 31. Epub 2021 Mar 31.

Department of Surgery, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand.

Acute diverticulitis is one of the leading gastrointestinal causes for hospitalization. The incidence of acute diverticulitis has been increasing in recent years, especially in patients under 50 years old. Historically, acute diverticulitis in younger patients was felt to represent a separate entity, being more virulent and associated with a higher rate of recurrence. Read More

Abdom Radiol (NY) 2021 Mar 25. Epub 2021 Mar 25.

Department of Surgery, Hospital Universitario Dr. Peset, Valencia, Spain.

Objective: To prospectively assess the diagnostic value of intestinal ultrasound (US) compared to computerized tomography (CT) in differentiating uncomplicated and complicated acute colonic diverticulitis (ACD).

Materials And Methods: During a period of 14 months patients referred to the department of Radiology with clinical suspicion of ACD underwent an US examination. All confirmed US ACD diagnosis were included and subsequently underwent an emergency abdominal CT, used as gold standard. Read More

BMJ 2021 03 24;372:n72. Epub 2021 Mar 24.

University of North Carolina School of Medicine, Chapel Hill, NC 27599-7555, USA

Left sided colonic diverticulitis is a common and costly gastrointestinal disease in Western countries, characterized by acute onset of often severe abdominal pain. Imaging is necessary to make an initial diagnosis and determine disease severity. Colonoscopy should be done six to eight weeks after diagnosis to rule out a missed colon malignancy. Read More

J Gastrointest Surg 2021 Mar 16. Epub 2021 Mar 16.

Department of Surgery, Massachusetts General Hospital, 15 Parkman Street, WACC 460, Boston, MA, 02114, USA.

Background: Patients with diverticular disease complicated by abscess and/or perforation represent the most severely afflicted with the highest mortality and poorest outcomes. This study investigated patient and operative factors associated with poor outcomes from diverticulitis complicated by abscess or perforation.

Methods: We analyzed the National Inpatient Sample to identify inpatient discharges for colonic diverticulitis in the United States from 1/1988 to 9/2015. Read More

World J Gastroenterol 2021 Mar;27(9):760-781

Division of Colorectal Surgery, Department of Surgery, City of Hope National Medical Center, Duarte, CA 91010-3000, United States.

Diverticular disease and diverticulitis are the most common non-cancerous pathology of the colon. It has traditionally been considered a disease of the elderly and associated with cultural and dietary habits. There has been a growing evolution in our understanding and the treatment guidelines for this disease. Read More

BMC Surg 2021 Mar 16;21(1):135. Epub 2021 Mar 16.

Department of Surgery, Campus Charité Mitte, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, 10178, Berlin, Germany.

Background: The best treatment for perforated colonic diverticulitis with generalized peritonitis is still under debate. Concurrent strategies are resection with primary anastomosis (PRA) with or without diverting ileostomy (DI), Hartmann's procedure (HP), laparoscopic lavage (LL) and damage control surgery (DCS). This review intends to systematically analyze the current literature on DCS. Read More

J Gastrointestin Liver Dis 2021 Mar 13;30(1):66-72. Epub 2021 Mar 13.

Department of Gastroenterology and Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Background And Aims: Colonic diverticulosis (CD) is among the most common conditions of the large bowel. Several factors have been associated with an increased risk of CD and its complications, including advanced age, obesity, physical inactivity, and a low-fiber diet. Available data is conflicting and a comprehensive analysis of different bowel, dietary and environmental habits linked with CD is lacking. Read More