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Abdom Radiol (NY) 2019 Feb 13. Epub 2019 Feb 13.

Department of Radiology, Fondation Hôpital Saint-Joseph, 185 rue Raymond Losserand, 75674, Paris, France.

Purpose: To present radiological aspects of jejunoileal diverticulosis and its complications.

Results: Jejunoileal diverticulosis is a relatively rare and underestimated condition, which mostly affects the elderly. It is frequently asymptomatic but it can lead to significant complications requiring surgical treatment. Read More

J Surg Case Rep 2019 Jan 31;2019(1):rjz005. Epub 2019 Jan 31.

Saint Vincent Hospital, Erie, PA, USA.

Cases of small bowel diverticulitis, excluding Meckel's diverticulitis, are rare. Small bowel diverticular disease has been reported in approximately 0.3-1. Read More

Inflamm Intest Dis 2018 Dec 20;3(2):75-79. Epub 2018 Jul 20.

Alta Bates Summit Medical Center, East Bay Center for Digestive Health, Oakland, California, USA.

Acute uncomplicated diverticulitis (AUD) is generally felt to be caused by obstruction and inflammation of a colonic diverticulum and occurs in about 4-5% of patients with diverticulosis. The cornerstone of AUD treatment has conventionally been antibiotic therapy, but with a paradigm shift in the underlying pathogenesis of the disease from bacterial infection to more of an inflammatory process, as well as concerns about antibiotic overuse, this dogma has recently been questioned. We will review emerging data that supports more selective antibiotic use in this population, as well as newer guidelines that advocate this position as well. Read More

Inflamm Intest Dis 2018 Dec 12;3(2):69-74. Epub 2018 Jul 12.

Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

Background: Colonic diverticulosis is the most common incidental lesion found on routine colonoscopy. However, its true natural history is unclear. The aim of this review is to examine the epidemiology of colonic diverticulosis and the incidence of complications, namely acute diverticulitis and diverticular hemorrhage. Read More

Inflamm Intest Dis 2018 Dec 7;3(2):61-68. Epub 2018 Aug 7.

Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.

Background: Colonic diverticulosis is prevalent and increasing not only in Western but also in Asian countries. Diverticulosis can be complicated by diverticulitis and diverticular bleeding. Diverticular disease is a burdensome digestive disease, because it is a major cause of hospital admissions and is associated with significant health-care costs. Read More

Inflamm Intest Dis 2018 Dec 28;3(2):55-60. Epub 2018 Jun 28.

Gastroenterology Service, ASL BAT, Andria, Italy.

Background: Diverticulosis of the colon is the most common anatomic alteration of the human colon, but the pathophysiologic mechanisms of its occurrence are not completely understood.

Summary: Constipation has been considered the key factor for diverticulosis occurrence. However, several fine papers questioned this pathogenetic hypothesis, showing on the contrary an inverse relationship between low number of bowel movements and diverticulosis occurrence. Read More

Connect Tissue Res 2019 Feb 5:1-10. Epub 2019 Feb 5.

f Waitemata District Health Board , University of Auckland, and Geriatrician , Auckland , New Zealand.

Purpose: An underlying connective tissue disorder (CTD) may predispose to formation of intestinal diverticula. We assess the association of diverticulosis with nine selected CTDs, to inform the pathophysiology of diverticula.

Methods: A population-based period-prevalence study. Read More

N Engl J Med 2019 01;380(5):500

Beth Israel Deaconess Medical Center, Boston, MA

N Engl J Med 2019 01;380(5):500

University Hospital 12 de Octubre, Madrid, Spain

N Engl J Med 2019 01;380(5):500-501

Mayo Clinic, Phoenix, AZ

Dis Colon Rectum 2019 Jan 25. Epub 2019 Jan 25.

Background: Acute diverticulitis is a common disease with public health significance. Many studies with a high level of evidence have been published recently on the surgical management of acute diverticulitis.

Objective: The aim of this systematic review was to define the accurate surgical management of acute diverticulitis. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2000-2002

Dept. of Surgery, Bellland General Hospital.

A 73-year-old man was admitted with sigmoid colon diverticulitis. Although a biopsy did not indicate malignancy, the sigmoid colon was completely obstructed following conservative treatment. After sigmoidectomy, the histopathological findings revealed a well-differentiated adenocarcinoma localized to the mucosal surface; invasive micropapillary carcinoma (IMPC)accounting for>95% of the tumor volume spread extensively below the submucosal layer. Read More

J Visc Surg 2019 Jan 23. Epub 2019 Jan 23.

Department of Digestive, Oncological, Endocrine, and Hepatic Surgery, and Hepatic Transplantation, Trousseau Hospital, 37000 Tours, France. Electronic address:

Aim Of The Study: Right colonic Diverticulitis (RD) is rare in Europe; few studies have focused on it and its management is not standardised. The aim of this study was to analyse the clinical presentation (complicated, uncomplicated), acute phase management and long-term outcome of RD in western countries.

Patients And Methods: From 2003 to 2017, 93 consecutive patients who presented with RD were retrospectively included at 11 French Hospital Centres. Read More

Tech Coloproctol 2019 Jan 25. Epub 2019 Jan 25.

Emergency Surgery Unit, Faculty of Medicine and Surgery, Torrette Hospital, Polytechnic University of Marche, Ancona, Italy.

Background: In Western countries, the incidence of acute diverticulitis (AD) is increasing. Patients with uncomplicated diverticulitis can undergo a standard antibiotic treatment in an outpatient setting. The aim of this systematic review was to assess the safety and efficacy of the management of acute diverticulitis in an outpatient setting. Read More

Dis Colon Rectum 2019 Jan 18. Epub 2019 Jan 18.

Background: Antibiotics are routinely used for diverticulitis irrespective of severity. Current practice guidelines favor against the use of antibiotics for acute uncomplicated diverticulitis.

Objective: We performed a systematic review and meta-analysis to examine the role of antibiotic use in an episode of uncomplicated diverticulitis. Read More

Dis Colon Rectum 2019 Jan 17. Epub 2019 Jan 17.

Background: Despite low-quality and conflicting evidence, the Association of Coloproctology of Great Britain and Ireland recommends the routine use of antibiotics in the treatment of uncomplicated acute diverticulitis. Recent studies have shown that treatment without antibiotics did not prolong recovery. Some new guidelines currently recommend selective use of antibiotics. Read More

Rev Gastroenterol Mex 2019 Jan 17. Epub 2019 Jan 17.

Servicio de Coloproctología, Hospital Regional de Veracruz, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Veracruz, Veracruz, México.

Gut 2019 Jan 19. Epub 2019 Jan 19.

Medical Department 1, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.

Objective: Diverticular disease is a common complex disorder characterised by mucosal outpouchings of the colonic wall that manifests through complications such as diverticulitis, perforation and bleeding. We report the to date largest genome-wide association study (GWAS) to identify genetic risk factors for diverticular disease.

Design: Discovery GWAS analysis was performed on UK Biobank imputed genotypes using 31 964 cases and 419 135 controls of European descent. Read More

Gastroenterology 2019 Jan 17. Epub 2019 Jan 17.

S-SPIRE Center and Department of Surgery, Stanford University, Stanford California, 1070 Arastradero Rd, Ste 217, CA 94305.

Diverticulitis is a prevalent gastrointestinal disorder that is associated with significant morbidity and health care costs. Approximately 20% of patients with incident diverticulitis have at least 1 recurrence. Complications of diverticulitis, such as abdominal sepsis, are less likely to occur with subsequent events. Read More

Scand J Gastroenterol 2019 Jan 16:1-5. Epub 2019 Jan 16.

a Colorectal Unit, Department of Surgery , Skåne University Hospital Malmö , Malmö, Sweden.

Objective: Routine antibiotic treatment of acute uncomplicated diverticulitis (AUD) has been shown ineffective. In this study, the adherence to a new treatment protocol for uncomplicated diverticulitis was evaluated and the incidence of complications in patients treated with and without antibiotics was investigated.

Materials And Methods: A retrospective study of in-patients diagnosed with AUD at Helsingborg Hospital, Sweden between 01 January 2013 and 06 January 2015 was performed. Read More

Clin Colon Rectal Surg 2019 Jan 8;32(1):8-15. Epub 2019 Jan 8.

Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota.

The Rochester Epidemiology Project (REP), a longitudinal population-based database, is the largest epidemiologic database in the world. Originally established at Mayo Clinic in Rochester, Minnesota, the REP has been instrumental in defining the natural history of disease states and the impact of treatment in a well-defined population. In the United States, the REP has made important contributions to the colon and rectal literature, largely because healthcare is fragmented with no unique identifier to longitudinally follow-up with a patient throughout the system over his or her lifespan. Read More

J Gastrointest Cancer 2019 Jan 10. Epub 2019 Jan 10.

Gastroenterology and endoscopy united, The Nazareth Hospital, EMMS, Nazareth, Israel.

Purpose: The aim of the present study was to determine the prevalence of underlying colorectal carcinoma (CRC) in a cohort of patients who experienced an episode of acute diverticulitis and to assess clinical and laboratory parameters that suggest CRC diagnosis.

Methods: We performed a single center retrospective study in EMMS Nazareth Hospital from April 2014 to April 2018. All Patients who experienced an episode of acute diverticulitis and underwent a colonoscopy up to 6-month period were included in the study. Read More

Can J Gastroenterol Hepatol 2018 6;2018:3690202. Epub 2018 Dec 6.

Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

Background: The natural history of colonic diverticulosis is unclear.

Methods: Patients with incidental diverticulosis identified in a previous prospective cross-sectional screening colonoscopy study were evaluated retrospectively for clinic or hospital visit(s) for diverticular disease (DD= acute diverticulitis or diverticular bleeding) using review of electronic health records and patient phone interview.

Results: 826 patients were included in the screening colonoscopy study. Read More

Digestion 2019 9;99 Suppl 1:1-26. Epub 2019 Jan 9.

Japanese Gastroenterological Association, Tokyo, Japan.

Colonic diverticular disease has been increasing in prevalence in Japan due to the rapidly aging population. Colonic diverticular bleeding can result in hemorrhagic shock requiring blood transfusion, and it carries a high risk of recurrence within 1 year. Colonic diverticulitis can cause abscess, fistula formation, and perforation of the colon that may require surgery, and it often recurs. Read More

J Minim Access Surg 2019 Jan 4. Epub 2019 Jan 4.

Surgical Services, University of Maryland Community Medical Group, University of Maryland, Easton; Meritus Surgical Specialists, Hagerstown, MD, USA.

Splenectomy together with colectomy is most commonly performed as a result of iatrogenic injury and not as an additional elective procedure. A 50-year-old African American female presented with recurrent episodes of diverticulitis. She had mediastinal, and porta hepatis lymphadenopathy and subcutaneous nodules, but multiple biopsies were unable to establish the diagnosis. Read More

Am Surg 2018 Dec;84(12):e529-e531

J Investig Med 2018 Dec 27. Epub 2018 Dec 27.

Gastroenterology Service, ASL BAT, Andria, Italy.

Although rifaximin is currently advised in managing symptomatic uncomplicated diverticular disease (SUDD) of the colon, no long-term data are available. This retrospective study assessed the outcome of a large cohort of patients with SUDD, treated with rifaximin, during an 8-year follow-up. The study group (group A) included 346 patients with SUDD (median age 64 years, IQR 58-69, 62. Read More

J Med Case Rep 2018 Dec 25;12(1):379. Epub 2018 Dec 25.

Computed Tomography Department, Konstantpouleio General Hospital Nea Ionia, Athens, Greece.

Background: Extramedullary plasmacytoma is an uncommon tumor that most often involves the nasopharynx or upper respiratory tract. Extramedullary plasmacytoma is a type of plasma cell neoplasm that can present as a primary tumor or secondary to another plasma cell neoplasm, such as multiple myeloma. Secondary extramedullary plasmacytoma is usually noted in the advanced stages of the disease. Read More

Dis Colon Rectum 2019 Mar;62(3):371-378

Department of Surgery, Weill Medical College of Cornell University, New York, New York.

Background: Uncomplicated colonic diverticulitis is common. There is no consensus regarding the most appropriate management. Some authors have reported the efficacy and safety of observational management, and others have argued for a more aggressive approach with oral or intravenous antibiotic treatment. Read More

Acta Biomed 2018 Dec 17;89(9-S):113-118. Epub 2018 Dec 17.

Department of Medicine and Surgery, University of Parma, Parma, Italy.

Colonic Diverticulosis is one of the most common anatomical findings during colonoscopy. This condition has 60% incidence in the population over 60 years old. About 20% of patients will develop Diverticular Disease, and 5% of them will evolve into Diverticulitis. Read More

Front Microbiol 2018 22;9:2853. Epub 2018 Nov 22.

Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan.

A novel species of carbapenemase-producing Enterobacteriaceae (CPE) was isolated from a patient diagnosed with sigmoid colon diverticulitis. At first, laboratory testing suggested it was or sp.; however, a complete genome sequence of the isolate, MRY16-398, revealed that it could be novel species, most similar to [] , of which taxonomic nomenclature is still under discussion. Read More

J Robot Surg 2018 Dec 10. Epub 2018 Dec 10.

Division of Colon and Rectal Surgery, St. Joseph Mercy Hospital, Ann Arbor, 5325 Elliott Dr., Suite #104, Ann Arbor, MI, 48106, USA.

Intracorporeal options for sigmoid resection have been recently developed but not extensively evaluated. This study was designed to assess outcomes comparing intracorporeal and extracorporeal techniques for robotic-assisted sigmoid resection in an established enhanced recovery pathway. This is a retrospective comparison of intracorporeal and extracorporeal techniques for robotic-assisted sigmoid resection for benign and malignant disease. Read More

Folia Med Cracov 2018 ;58(3):83-87

Department of Internal Medicine, General Hospital of Veria, Veria, Greece.

Meckel's diverticulum represents a remnant of the proximal end of the omphalomesenteric duct, which constitutes a connection between the middle intestine and the vitelline vesicle. It is the most common congenital anomaly of the gastrointestinal tract and is found in approximately 0.3-2% of the general population. Read More

Dig Dis Sci 2018 Dec 3. Epub 2018 Dec 3.

Division of Colon and Rectal Surgery, Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA, 17033-0850, USA.

Background: The management of diverticulitis is compromised by difficulty in identifying patients who require surgery for recurrent or persistent disease. Here, we introduce the concept of multifocal diverticulitis (MFD), characterized by multiple episodes of diverticulitis occurring at different locations within the colon.

Aims: To compare clinical characteristics, success of surgical management, and colonic transcriptomes of MFD patients to patients with conventional unifocal diverticulitis (UFD). Read More

Eur Radiol 2018 Dec 3. Epub 2018 Dec 3.

Department of Radiology, Konstantopouleion Hospital, Agias Olgas 3, Nea Ionia, 142 33, Athens, Greece.

Key Point: • The term "pericolic" is wrongly used to describe an abscess adjacent to the colon in patients with acute diverticulitis. We explain why the proper term is the word "paracolic." Read More

ANZ J Surg 2018 Nov 29. Epub 2018 Nov 29.

Department of Surgery, St George Hospital, Sydney, New South Wales, Australia.

Am J Case Rep 2018 Nov 22;19:1386-1392. Epub 2018 Nov 22.

Third Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, School of Health Sciences, Faculty of Medicine, Thessaloniki, Greece.

BACKGROUND Although diverticular disease is well described and treated in daily clinical practice, there are cases that attract great interest because of their complexity and difficulty in management. Herein, we describe a rare case of colo-colonic fistula-complicated diverticulitis that necessitated urgent surgical intervention. CASE REPORT A 76-year-old female patient with a known history of diverticular disease of the sigmoid colon presented in the Emergency Department for evaluation of left lower quadrant abdominal pain. Read More

Tech Coloproctol 2018 10 20;22(10):739-740. Epub 2018 Nov 20.

Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Dis Colon Rectum 2019 Jan;62(1):71-78

Colorectal Surgery Center, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.

Background: Current guidelines accept partial colectomy and primary anastomosis with proximal diversion for select patients with perforated diverticulitis based on low-quality evidence.

Objective: This study aimed to compare the effect of operative approach and surgeon training on outcomes following urgent/emergent colectomy for diverticulitis.

Design: This is a statewide retrospective cohort study. Read More

Int J Surg Case Rep 2018 1;53:259-261. Epub 2018 Nov 1.

Department of Surgery, Institute of Gastroenterology, Kawasaki Saiwai Hospital, Kawasaki, Japan.

Introduction: The self-expanding metal stent (SEMS) has been used in malignant colorectal obstruction as a bridge to surgery or for palliative treatment. We report a case of obstructive descending colon diverticulitis in-stent restenosis, which is difficult to distinguish from colon cancer.

Presentation Of Case: A 48-year-old man presented with abdominal pain. Read More

Dig Surg 2018 Nov 8:1-5. Epub 2018 Nov 8.

Department of Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.

Background: Right colonic diverticulitis (RCD) is more common in Asian countries than in Western countries, and the risk factors for recurrence of RCD are not fully understood. The objective of this study was to assess the risk factors for recurrence of RCD.

Methods: We analyzed 296 patients admitted for treatment of RCD in the Gachon University Gil Medical Center from December 2001 to October 2014. Read More

Medicine (Baltimore) 2018 Nov;97(45):e13176

Department and Clinic of Gastrointestinal and General Surgery, Medical University, Wroclaw. Poland.

Rationale: Retroperitoneal colonic perforation is a rare cause of retroperitoneal abscess. It presents, more frequently in frail elderly patients, with heterogeneous signs and symptoms which hamper the clinical diagnosis. Subcutaneous emphysema with pneumomediastinum and iliopsoas muscle abscess are unusual signs. Read More

Curr Opin Gastroenterol 2019 Jan;35(1):27-33

Division of Gastroenterology and Hepatology, Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas, USA.

Purpose Of Review: Irritable bowel syndrome (IBS) is a common symptomatic disorder in the Western world and colonic diverticula are also prevalent; however, relationships between IBS-type symptoms and diverticula have been a source of much debate. Our goal was to reassess these relationships in the light of new data.

Recent Findings: On removing from consideration clinical scenarios which are directly related to diverticula (i. Read More

Surg Endosc 2018 Nov 7. Epub 2018 Nov 7.

Department of General e Surgery, Ospedale Citta Sesto San Giovanni, ASST Milano Nord, Sesto San Giovanni, Italy.

Background: Recently, minimally invasive treatment of complicated sigmoid diverticulitis is becoming a valid alternative to standard procedures. Robotic approach may be useful to allow more precise dissection in arduous pelvic dissection as in complicated diverticulitis. The aim of this study is to investigate effectiveness, potential benefits and short-term outcomes of robotic-assisted laparoscopic surgical resection, compared with fully laparoscopic resection in complicated diverticulitis. Read More

North Clin Istanb 2018 15;5(2):148-152. Epub 2018 Mar 15.

Department of Pathology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.

Solitary cecal diverticulitis is a rare clinical condition. Like diverticulitis in other segments of the colon, it requires immediate surgical intervention if it is causing complications. Solitary cecal diverticulitis may be misdiagnosed as acute appendicitis, since it causes right lower quadrant pain, or as a cecal tumor or inflammatory bowel disease, due to an intraoperative appearance resembling an inflammatory mass. Read More

Dis Colon Rectum 2018 12;61(12):1442-1453

Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

Background: The traditional approach for perforated diverticulitis, the Hartmann procedure, has considerable morbidity and the challenge of stoma reversal. Alternative procedures, including primary resection and anastomosis and laparoscopic lavage, have been proposed but remain controversial.

Objective: The purpose of this study was to compare operative strategies for perforated diverticulitis. Read More

World J Emerg Surg 2018 15;13:47. Epub 2018 Oct 15.

2Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain, 17666 United Arab Emirates.

The use of point-of-care ultrasound (POCUS) by non-radiologists has dramatically increased. POCUS is completely different from the routine radiological studies. POCUS is a Physiological, On spot, extension of the Clinical examination, that is Unique, and Safe. Read More

N Engl J Med 2018 Oct;379(17):1635-1642

From the Division of Colon and Rectal Surgery, Mayo Clinic, Phoenix, AZ.

Scand J Gastroenterol 2018 Oct - Nov;53(10-11):1298-1303. Epub 2018 Oct 24.

b Colorectal Unit, Department of Surgery , Västmanlands Hospital Västerås , Sweden.

Objectives: The aim of this study was to describe patient characteristics and results of non-operative management for patients presenting with computed tomography (CT) verified perforated diverticulitis with extraluminal or free air.

Methods: All patients treated for diverticulitis (ICD-10: K-57) during 2010-2014 were identified and medical records were reviewed. Re-evaluations of CT examinations for all patients with complicated disease according to medical records were performed. Read More

Br J Surg 2018 Oct 18. Epub 2018 Oct 18.

Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA.

Background: Studies examining long-term outcomes following resolution of an acute diverticular abscess have been limited to single-institution chart reviews. This observational cohort study compared outcomes between elective colectomy and non-operative management following admission for an initial acute diverticular abscess.

Methods: The Statewide Planning and Research Cooperative System was queried for unscheduled admissions for an initial acute diverticular abscess in 2002-2010. Read More