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BMJ Case Rep 2019 Apr 15;12(4). Epub 2019 Apr 15.

Department of Hepatopancreaticobiliary Surgery, Cambridge University Hospital, Cambridge, Cambridgeshire, UK.

Portal pyaemia or pylephlebitis is a form of septic (often suppurative) thrombophlebitis of the portal venous system. It may develop as a complication of intra-abdominal sepsis, such as diverticulitis or appendicitis. Patients typically present with a high fever that is sometimes accompanied by jaundice. Read More

Tech Coloproctol 2019 Apr 16. Epub 2019 Apr 16.

Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

J Surg Case Rep 2019 Apr 6;2019(4):rjz102. Epub 2019 Apr 6.

Department of General Surgery, Joondalup Health Campus, Joondalup, Western Australia, Australia.

Chronic abdominal pain is often a diagnostic dilemma. We present a 59-year-old female with chronic generalized colicky abdominal and altered bowel habits. She was investigated with colonoscopy and CT abdomen. Read More

Clin J Gastroenterol 2019 Apr 6. Epub 2019 Apr 6.

Department of Pediatrics, Jichi Medical University, Shimotsuke, Tochigi, Japan.

Duodenocolic fistula (DCF) is a rare disorder defined by the presence of an internal fistula between the duodenum and colon. Colon cancer, Crohn's disease, diverticulum and duodenal ulcer are common causes of DCF, and vomiting and diarrhea are its main symptoms. We report a 14-year-old boy with DCF who had been treated for a functional gastrointestinal disorder (FGID). Read More

Colorectal Dis 2019 Apr 1. Epub 2019 Apr 1.

General Surgeon, İzmir Katip Çelebi University Atatürk Training and Research Hospital, Department of General Surgery.

Colonic diverticulosis is a common condition in modern society due to nutritional habits and lifestyle [1]. Treatment of acute diverticulitis varies from conservative treatment to colonic resection according to the severity of the inflammation which is usually determined with clinical presentation and imaging findings [2]. This article is protected by copyright. Read More

Surg Infect (Larchmt) 2019 Mar 30. Epub 2019 Mar 30.

3 Department of Surgery, Amsterdam UMC, Amsterdam, The Netherlands.

Background: Although uncomplicated acute diverticulitis has a benign disease course, some patients are at increased risk for complications. Identification of these patients may aid the selection of treatment strategies such as outpatient treatment. This study aimed to assess the rate and timing of a complicated disease course in initially computed tomography (CT)-proven uncomplicated diverticulitis, and to identify risk factors for the development of these diverticular complications. Read More

Am J Surg 2019 Mar 5. Epub 2019 Mar 5.

Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, FL, USA. Electronic address:

Background: Minimally invasive surgery (MIS) in patients with diverticulitis is advantageous relative to open surgery. We aimed to determine disparities associated with MIS access for diverticulitis and post-operative complications.

Methods: The Florida Inpatient Discharge Dataset was retrospectively queried for patients with diverticulitis undergoing elective surgery between 2013 and 2015. Read More

Diagn Pathol 2019 Mar 13;14(1):22. Epub 2019 Mar 13.

Department of Radiology, Maisonneuve-Rosemont Hospital, 5415 Boulevard de L'Assomption, Montreal, QC, Canada.

Background: Malakoplakia is a chronic inflammatory disease characterized by tissue infiltrates of large granular macrophages containing distinctive intracytoplasmic inclusions termed Michaelis-Gutmann (MG) bodies. The genitourinary system is the most commonly involved site, followed by the gastrointestinal tract. Malakoplakia may occur as a complication of primary or secondary immunosuppression and, therefore, renal transplant recipients are at risk. Read More

AJR Am J Roentgenol 2019 Mar 12:1-6. Epub 2019 Mar 12.

1 Department of Emergency Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114.

Objective: The purpose of this study was to evaluate the association between the diagnostic certainty expressed by the wording of CT report impressions and subsequent use of standard treatment with analgesics versus nonstandard antibiotic administration in patients with acute epiploic appendagitis (EA).

Materials And Methods: Demographic, clinical, and radiologic data from a 10-year cohort of patients with acute EA were retrospectively analyzed and correlated with standard treatment with analgesics versus nonstandard treatment with antibiotics. A level of certainty was assigned to the CT report language based on the wording of the impression statements by two radiologists; their interreader agreement was assessed with kappa statistics. Read More

J Gastrointest Surg 2019 Mar 11. Epub 2019 Mar 11.

Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.

Background: Recently published studies advocate a conservative approach with observation and antibiotic treatment in diverticulitis patients with pericolic air on computed tomography (CT). The primary aim of this study was to assess the clinical course of initially conservatively treated diverticulitis patients with isolated pericolic air and to identify risk factors for conservative treatment failure. The secondary aim was to assess the outcome of non-antibiotic treatment. Read More

World J Gastrointest Surg 2019 Feb;11(2):41-52

Division of Colon and Rectal Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

Enhanced recovery after surgery (ERAS), a multidisciplinary program designed to minimize stress response to surgery and promote the recovery of organ function, has become a standard of perioperative care for elective colorectal surgery. In an elective setting, ERAS program has consistently been shown to decrease postoperative complication, reduce length of hospital stay, shorten convalescence, and lower healthcare cost. Recently, there is emerging evidence that ERAS program can be safely and effectively applied to patients with emergency colorectal conditions such as acute colonic obstruction and intraabdominal infection. Read More

Am Surg 2018 Aug;84(8):e275-e276

Cureus 2018 Dec 19;10(12):e3753. Epub 2018 Dec 19.

Surgery, The Queen Elizabeth Hospital, Adelaide, AUS.

Meckel's Diverticulum is one of the most common congenital anomalies of the gastrointestinal tract. However, its presentation as a complicated Giant Meckel's Diverticulum in an adult is rare. We present a case of a perforated Giant Meckel's mimicking ischemia of the right colon. Read More

Dis Colon Rectum 2019 May;62(5):608-614

Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.

Background: Although acute diverticulitis and its recurrence are well studied, little is known about the period after these attacks have passed. Many patients appear to be affected by persistent symptoms that impair quality of life. The few published studies on this topic are mostly limited by the lack of CT confirmation of the acute diverticulitis diagnosis, low numbers of patients, or cross-sectional design. Read More

J Surg Case Rep 2019 Feb 8;2019(2):rjy368. Epub 2019 Feb 8.

Department of General Surgery, Rockhampton Hospital, Central Queensland Health, Canning Street Rockhampton, Queensland 4700, Australia.

Accidental ingestion of foreign bodies can be a common occurrence in clinical practice and subsequent perforation is quite rare. The rate of fish bone ingestion is predicted to be higher in some cultures given culinary differences. We report a case of 62-year-old gentleman in rural Australia who had severe left sided abdominal pain and fevers, with a presumptive diagnosis of diverticulitis. Read More

Int J Surg Case Rep 2019 10;55:213-217. Epub 2019 Feb 10.

Department of Acute Care Surgery, Shimane University, Faculty of Medicine, Shimane, Japan.

Introduction: Mediastinal and subcutaneous emphysema usually result from spontaneous rupture of the alveolar wall. We present an extremely rare case of massive mediastinal, retroperitoneal, and subcutaneous emphysema due to the penetration of the colon into the mesentery.

Presentation Of Case: A 57-year-old man presented to our institution with a history of chest pain. Read More

Int J Colorectal Dis 2019 May 15;34(5):933-938. Epub 2019 Feb 15.

Department of Surgery, Northwest Clinics, Wilhelminalaan 12, 1815 JD, Alkmaar/Den Helder, Netherlands.

Purpose: The underling pathophysiological mechanisms that cause the formation of colonic diverticula (diverticulosis) remain unclear. Connective tissue changes due to ageing that cause changes in collagen structure of the colonic wall is one theory. Alpha-1-antitrypsin (A1AT) is a protease inhibitor known to protect connective tissue in other organs. Read More

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

Am Surg 2018 Oct;84(10):1608-1612

Department of General Surgery, Arrowhead Regional Medical Center, Colton, California, USA.

Right-side diverticulitis (RSD) is an uncommon disease in Western countries. We conducted a case-matched comparison of surgically managed right-side and left-side diverticulitis (LSD) from the Southern California Kaiser Permanente database (2007-2014). Of 995 patients undergoing emergent surgery for diverticulitis, 33 RSD (3. 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 Feb 25;23(2):87-100. 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 - Mar;84(1):104-105. 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 05 19;68(5):854-865. 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 04 17;156(5):1282-1298.e1. Epub 2019 Jan 17.

S-SPIRE Center and Department of Surgery, Stanford University, Stanford, California.

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;54(1):64-68. 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 2019 Apr 27;67(4):767-770. 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