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Tech Coloproctol 2020 May 27. Epub 2020 May 27.

Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, USA.

Background: The most common etiology of colovesical fistulas is complicated diverticular disease and the treatment of choice is surgical resection. There are very few reports of the application of minimally invasive approaches for these surgeries. The aim of our study was to evaluate the role of laparoscopy in this challenging surgical setting. Read More

Eur J Radiol 2020 Apr 30;128:109026. Epub 2020 Apr 30.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States.

Diverticular disease of the colon and small bowel is an important cause of pathology leading to emergency department visits and urgent gastrointestinal surgery. CT is a highly sensitive and specific modality for the diagnosis of acute diverticulitis and its complications as well as for the exclusion of alternate causes of pathology. Ultrasound, MRI and virtual CT colonoscopy have important adjunct roles for screening and workup of complications in specific patient populations. Read More

Maedica (Buchar) 2020 Mar;15(1):105-110

Pitesti Emergency Hospital, Arges, Romania.

Diverticular disease is a common condition among the elderly, with a steady increase in prevalence over time. Also, it has a temporal, geographic, and ethnic variation in incidence and prevalence, the genetic component having only recently been studied. For many years, environmental factors were the main link to the etiology. Read More

Dig Dis Sci 2020 May 12. Epub 2020 May 12.

Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.

Background: Elevated colonic pressures and increased colonic activity have been thought to contribute to the pathophysiology of diverticulosis. However, evidence for this has been limited to low-resolution manometry, which is of limited accuracy.

Aims: This study aimed to evaluate the contraction pressures, counts, and distance of propagation recorded by high-resolution colonic manometry in diverticulosis vs control patients. Read More

Case Rep Gastroenterol 2020 Jan-Apr;14(1):165-171. Epub 2020 Apr 17.

Southmead Hospital, North Bristol Trust, Bristol, United Kingdom.

Pyogenic liver abscesses, despite being a rare complication of diverticulitis and inflammatory bowel disease, are potentially serious life-threatening pathologies. Diverticular diseases can lead to disruption of the colonic mucosal barrier and can serve as a route for bacterial infection via the portal venous system. This patient had such a delayed presentation due to his atypical symptoms; he developed large abscess formation, detected by computed tomography, eventually requiring an ultrasound-guided drain followed by a colonoscopy. Read More

Am Surg 2020 Apr;86(4):e183-e184

Am Surg 2020 Apr;86(4):308-312

From the *School of Medicine, Griffith University, Gold Coast, Australia and.

Acute diverticulitis is an emergency surgical condition that is commonly managed an acute surgical unit model. Operative surgery is indicated in selected situations including generalized peritonitis or fistulous disease; however, limited data exist on how borderline patients potentially needing surgery may be salvaged by close clinical management with modern interventional techniques. The aims of the study were to identify the operative surgery rates in acute diverticulitis and predictors for identifying patients with complicated diverticulitis. Read More

Dis Colon Rectum 2020 Jun;63(6):715-717

Department of Surgery, University of Florida, Gainesville, Florida.

Kurume Med J 2020 May 1. Epub 2020 May 1.

Dental and Oral Medical Center, Kurume University School of Medicine.

Diverticular pouch in the oral cavity is a rare disease, and its etiology is unclear. The authors present a rare case of diverticular pouch in the buccal mucosa. A 79-year-old man visited our hospital with a chief complaint of food impaction in the right buccal mucosa. Read More

Ann R Coll Surg Engl 2020 May 6:e1-e3. Epub 2020 May 6.

Department of General Surgery, University Hospital Monklands, Airdrie, UK.

A 62-year old man who presented unwell with no specific symptoms or signs was found to have portal venous circulation gas complicating a small diverticular abscess. He was successfully managed with a course of antibiotics and had full resolution of symptoms, therefore avoiding the need for surgical intervention. While most commonly associated with bowel ischaemia and therefore often warranting emergency laparotomy, portal venous gas within the context of other underlying pathology often presents opportunities for delayed surgery or more conservative management options. Read More

Tech Coloproctol 2020 May 4. Epub 2020 May 4.

Department of Surgery, Division of General Surgery, Section of Colorectal Surgery, University of British Columbia, Vancouver, BC, Canada.

Khirurgiia (Mosk) 2020 (4):70-73

Sklifosovsky Research Institute of Emergency Care of the Moscow Healthcare Department, Moscow, Russia.

Gastric diverticulum is a rather rare disease. This lesion is diagnosed in about 0.01% of cases during contrast-enhanced X-ray examination and in 0. Read More

Nat Rev Dis Primers 2020 04 29;6(1):35. Epub 2020 Apr 29.

IBD Unit, Humanitas Clinical Research Hospital, Rozzano, Milan, Italy.

An amendment to this paper has been published and can be accessed via a link at the top of the paper. Read More

Ann Emerg Med 2020 05;75(5):576-586

Department of Radiology, Lincoln Medical and Mental Health Center, Bronx, NY.

Lancet Gastroenterol Hepatol 2020 Apr 20. Epub 2020 Apr 20.

Colorectal Surgery Unit, Bellvitge University Hospital, Department of General and DIigestive Surgery-Colorectal Unit, University of Barcelona and Institut d'Investigacio Biomedica de Bellvitge, Barcelona, Spain.

Background: Previous studies have found that mechanical bowel preparation with oral antibiotics can reduce the incidence of surgical-site infections, but no randomised controlled trial has assessed oral antibiotics alone without mechanical bowel preparation. The aim of this study was to determine whether prophylaxis with oral antibiotics the day before elective colon surgery affects the incidence of postoperative surgical-site infections.

Methods: In this multicentre, pragmatic, randomised controlled trial (ORALEV), patients undergoing colon surgery were recruited from five major hospitals in Spain and 47 colorectal surgeons at these hospitals participated. Read More

Cureus 2020 Mar 18;12(3):e7303. Epub 2020 Mar 18.

Surgery, University of Queensland, Brisbane, AUS.

Pneumoperitoneum, or the accumulation of free air in the peritoneal cavity, is commonly associated with visceral perforation, mandating emergent surgical intervention. Non-surgical pneumoperitoneum, where visceral perforation is not the cause, does not commonly require surgical management. Chronic pneumoperitoneum secondary to small bowel diverticulosis is rare. Read More

Pol Przegl Chir 2020 Apr;92(2):22-28

Klinika Chirurgii Kolorektalnej, Ogólnej i Onkologicznej, Centrum Medyczne Kształcenia Podyplomowego w Warszawie.

Introduction: Background: Diverticulosis is the most common finding in the GI tract. Nearly half of the people with diverticula experience symptomatic uncomplicated diverticular disease (SUDD).

Aims: The primary endpoints of our study were to assess the effectiveness of combined therapy with rifaximin-α and arabinogalactan-lactoferrin in symptom reduction and normalization of bowel movements. Read More

ACG Case Rep J 2019 Nov 28;6(11):e00253. Epub 2019 Nov 28.

Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Segmental colitis associated with diverticulosis (SCAD) is a rare inflammatory condition affecting segments of the colon with diverticular disease. We present an 85-year-old woman with flank pain, fevers, and chills found on imaging to have left colonic wall thickening and left-sided hydroureteronephrosis and workup confirming a diagnosis of SCAD. A detailed review of SCAD and discussion of the differential diagnosis are provided. Read More

Colorectal Dis 2020 Apr 16. Epub 2020 Apr 16.

Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway.

Aim: Routine colonoscopy to exclude colorectal cancer (CRC) after CT-verified acute diverticulitis is controversial. This study aimed to compare the incidence of CRC in patients with acute diverticulitis with that in the general population.

Method: Patients with an emergency admission for diverticular disease to any Norwegian hospital between 1 January 2008 and 31 December 2010 were included through identification in the Norwegian Patient Registry using International Classification of Diseases (ICD-10) codes K57. Read More

PLoS One 2020 9;15(4):e0229884. Epub 2020 Apr 9.

First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.

Objective: We evaluated the characteristics of patients with diverticular bleeding in whom emergency endoscopy should be proactively performed and those in whom it is unnecessary for spontaneous hemostasis following conservative treatment.

Methods: This study involved 132 patients in whom diverticular bleeding was diagnosed on lower gastrointestinal endoscopy. We evaluated the rate of identification of the bleeding diverticulum during endoscopy and the rate of spontaneous hemostasis following conservative treatment. Read More

Colorectal Dis 2020 Apr 5. Epub 2020 Apr 5.

Department of Public Health, School of Medicine, University of Naples Federico II - Minimally Invasive General and Oncological Surgery Unit, Napoli, Italy.

Am Surg 2020 Mar;86(3):e108-e110

Nat Rev Dis Primers 2020 03 26;6(1):20. Epub 2020 Mar 26.

IBD Unit, Humanitas Clinical Research Hospital, Rozzano, Milan, Italy.

Diverticula are outpouchings of the intestinal wall and are common anatomical alterations detected in the human colon. Colonic diverticulosis (the presence of diverticula in the colon; referred to as diverticulosis) remains asymptomatic in most individuals but ~25% of individuals will develop symptomatic diverticulosis, termed colonic diverticular disease (also known as diverticular disease). Diverticular disease can range in severity from symptomatic uncomplicated diverticular disease (SUDD) to symptomatic disease with complications such as acute diverticulitis or diverticular haemorrhage. Read More

Nat Rev Dis Primers 2020 03 26;6(1):21. Epub 2020 Mar 26.

Gut 2020 Mar 26. Epub 2020 Mar 26.

Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia.

Thoracic oesophageal diverticula are often associated with spastic motility disorders. Despite correction of the underlying motility disorder, in a subgroup of patients, symptoms persist, primarily regurgitation. Surgical diverticulectomy is then proposed; however, as the approach is thoracoscopic or via thoracotomy, it is associated with significant morbidity and cost. Read More

J Eval Clin Pract 2020 Mar 25. Epub 2020 Mar 25.

Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Rationale: The aim of this study was to identify temporal readmission patterns according to baseline disease categories to provide opportunities for targeted interventions.

Methods: Retrospective analysis of consecutive adult (≥18 years) patients who underwent elective colorectal resections (2011-2017) at Mayo Clinic Rochester, MN. A prospective administrative database including patient demographics, procedure characteristics, discharge information and specifics on 30-day readmissions (to index facility) including timing and reasons was utilized. Read More

BMJ Open 2020 Mar 24;10(3):e034385. Epub 2020 Mar 24.

Salzburger Universitätsklinikum, Salzburg, Austria.

Introduction: Diverticulitis is among the most common abdominal disorders. The best treatment strategy for this complicated disease as well as for recurrent stages is still under debate. Moreover, little knowledge exists regarding the effect of different therapeutic strategies on the health-related quality of life (HrQoL). Read More

Scand J Gastroenterol 2020 Apr 23;55(4):454-459. Epub 2020 Mar 23.

Surgical Department, Center for Clinical Research, Uppsala University, Västmanland Hospital, Vasteras, Sweden.

The purpose of this study was to evaluate the disease pattern and treatment of diverticular abscesses. Patients treated for diverticulitis (K57) in Västmanland, Sweden were identified for this retrospective population-based study between January 2010 and December 2014. Patients with diverticular abscesses were included. Read More

Zhonghua Yi Xue Za Zhi 2020 Mar;100(9):702-705

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

To analyze the correlative factors of sigmoid sinus diverticulum(SSD) formation in individuals without pulsatile tinnitus based on computed tomography angiography (CTA). A hospital-based 1∶2 matched case-control study was performed on 42 cases with unilateral SSD and 84 controls for age, gender, and side-matched in Beijing Friendship Hospital affiliated to the Capital Medical University from January 2018 to December 2018.The signs including sigmoid sinus wall dehiscence, venous outflow dominance, transverse sinus stenosis, high jugular bulb, large emissary veins, degree of mastoid pneumatization (grade Ⅰ-Ⅳ) and empty sella, were detected and analyzed. Read More

Surg Endosc 2020 Mar 16. Epub 2020 Mar 16.

Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, MD, USA.

Background: Introduction of the full-thickness resection device (FTRD) has allowed endoscopic resection of difficult lesions such as those with deep wall origin/infiltration or those located in difficult anatomic locations. The aim of this study is to assess the outcomes of the FTRD among its early users in the USA.

Methods: Patients who underwent endoscopic full-thickness resection (EFTR) for lower gastrointestinal tract lesions using the FTRD at 26 US tertiary care centers between 10/2017 and 12/2018 were included. Read More

Internist (Berl) 2020 Apr;61(4):411-415

Abteilung für Geriatrie, Zentrum für Allgemeinmedizin und Geriatrie, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.

Pneumonia and in particular aspiration pneumonia, is a common disease in geriatrics. These aspirations are often due to dysphagia, which is frequently first noticed in the context of a geriatric assessment. The reasons for dysphagia are manifold. Read More

BMJ Case Rep 2020 Mar 10;13(3). Epub 2020 Mar 10.

Intensive Care Unit, Queensland Health, Gold Coast, Queensland, Australia

A 73-year-old woman was admitted to the intensive care unit following vomiting and diarrhoea onset after completing oral bowel preparation prior to colonoscopy to investigate haematochezia. She had a history of severe chronic obstructive pulmonary disease, Crohn's disease, diverticular disease, hypertension and dyslipidaemia. She was resuscitated with intravenous fluids, antibiotics and required epinephrine, norepinephrine and vasopressin infusions. Read More

Endosc Int Open 2020 Mar 21;8(3):E377-E385. Epub 2020 Feb 21.

Department of Gastroenterology and Hepatology, Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan.

 The efficacy of endoclips for colonic diverticular hemorrhage remains unclear. The aim of the current study was to evaluate the safety and efficacy of endoclips versus endoscopic band ligation (EBL) for the treatment of colonic diverticular hemorrhage. At Nara City Hospital, 93 patients with colonic diverticular hemorrhage with stigmata of recent hemorrhage (SRH) were treated using endoclips or EBL between January 2013 and December 2018. Read More

Cureus 2020 Jan 19;12(1):e6702. Epub 2020 Jan 19.

Breast and General Surgery, Civil Hospital, Dow University of Health Sciences, Karachi, PAK.

Meckel's diverticulum (MD), a congenital abnormality of the gastrointestinal tract, is usually found in the pediatric population younger than two years of age; hence, its incidence in adults is rare. Although MD is mostly clinically silent, in adults, it may present with intestinal obstruction and diverticulitis. The complications of MD include hemorrhage, perforation, enterolith formation, torsion, Littre's hernia, ulceration and neoplasm. Read More

Intern Med J 2020 Mar 1. Epub 2020 Mar 1.

Consultant Gastroenterologist, Department of Gastroenterology, Tauranga Hospital, Bay of Blenty District Health Board, New Zealand.

Background And Aim: Post-colonoscopy colorectal cancers (PCCRC) are cancers which appear following a colonoscopy in which no cancer is diagnosed. The occurrence of PCCRC is thought to be multifactorial, reflecting both endoscopy quality as well as potential differences in tumour biology between detected colorectal cancers and PCCRC. We sought to identify the prevalence and characteristics of PCCRC in a New Zealand regional centre over a 10-year period. Read More

Sci Rep 2020 Feb 27;10(1):3643. Epub 2020 Feb 27.

Service de chirurgie digestive, endocrinienne et générale, CHU de Limoges, Avenue Martin Luther King, Limoges Cedex, 87042, France.

Hartmann's reversal procedures are often fraught with complications or failure to recover. This being a fact, it is often difficult to select patients with the optimal indications for a reversal. The post-recovery morbidity and mortality rates in the literature are heterogeneous between 0. Read More

Int Urol Nephrol 2020 Feb 25. Epub 2020 Feb 25.

Division of Urology, Cook County Health and Hospitals System, Chicago, IL, USA.

Purpose: The objective of this study was to assess the accuracy of cystoscopy and cystography, as compared to other diagnostic studies, in identifying vesicoenteric fistulae (VEF) in a contemporary series of patients with surgically confirmed VEF.

Methods: With institutional review board approval, we performed a single-center retrospective review of surgically confirmed VEF between 2002 and 2018. Demographic data, comorbidities, symptoms, and diagnostic evaluation were reviewed. Read More

Pol Arch Intern Med 2020 03 20;130(3):232-239. Epub 2020 Feb 20.

Diverticulosis of the colon is the most common anatomic alteration of the human colon. Diet may be important in the management of diverticular disease (DD). It is known that high‑fiber diet does not prevent diverticulosis, and there are conflicting data on the prevention and treatment of DD and acute diverticulitis. Read More

Am Surg 2020 Jan;86(1):49-55

After elective sigmoidectomy for diverticulitis, patients may experience persistent abdominal symptoms. This study aimed to determine the incidence and characteristics of persistent symptoms (PSs) and their risk factors in patients who had no reported recurrence after elective sigmoidectomy. Patients who underwent elective sigmoidectomy for diverticulitis from 2002 to 2016 at a tertiary academic colorectal surgery practice were included. Read More

Zhonghua Wai Ke Za Zhi 2020 Feb;58(2):137-141

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Engineering Research Center for Vascular Prostheses, Beijing 100029, China.

To examine the outcomes of surgical treatment in patients of type Stanford A aortic dissection with Kommerell's diverticulum. From January 2009 to August 2017, patients of type Stanford A aortic dissection with Kommerell's diverticulum who underwent the Sun procedure were enrolled. Patient demographic, preoperative, intraoperative, early morbidity and mortality data were collected from medical and electronic patient records. Read More

Surg Endosc 2020 Feb 18. Epub 2020 Feb 18.

Department of General Surgery, St John of God Midland Hospital, 1 Clayton Street, Midland, WA, 6056, Australia.

Background: Diverticular disease has been linked to obesity. Recent studies have assessed the role of visceral adiposity with diverticulitis and its complications. The aim of this study was to evaluate the association of quantitative radiological measures of visceral adiposity in patients with diverticulitis with vital signs, biochemistry results, uncomplicated versus complicated diverticulitis and its interventions. Read More

ANZ J Surg 2020 01;90(1-2):190

Department of Pathobiology and Medical Diagnostic, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia.

ANZ J Surg 2020 01;90(1-2):188

Department of Surgery, University of Texas Health Science Center, San Antonio, Texas, USA.

ANZ J Surg 2020 01;90(1-2):188-189

Department of Surgery, School of Medical Sciences, Universiti Malaysia Sabah, Kota Bharu, Kelantan, Malaysia.

ANZ J Surg 2020 01;90(1-2):189-190

Department of Pathology, Neuberg Supratech Laboratory, Mehsana, India.

World J Gastrointest Endosc 2020 Feb;12(2):53-59

Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States.

Diverticula are the most common incidental finding during routine colonoscopy, and their prevalence increases with patient age. The term "diverticular disease" encompasses the range of clinical manifestations and complications that can occur with colonic diverticula, including diverticular bleeding, diverticulitis-associated strictures, and acute diverticulitis. Colonoscopy is a vital tool in the diagnosis and management of diverticular disease and can be useful in a variety of regards. Read More

Can Assoc Radiol J 2020 May 5;71(2):149-153. Epub 2020 Feb 5.

Department of Radiology, University of Yamanashi, Chuo-shi, Yamanashi, Japan.

Meckel diverticulum is the most common and well-known congenital anomaly of the digestive system. Although most cases are asymptomatic, Meckel diverticulum can have a variety of complications, including gastrointestinal bleeding as a result of peptic ulceration, diverticulitis, and small bowel obstruction. Although the radiologic findings of these complications have been reported, they are difficult to diagnose preoperatively because Meckel diverticulum is a small entity. Read More

Int J Surg Case Rep 2020 7;67:196-199. Epub 2020 Feb 7.

Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, 68, Hangeulbiseok-ro, Nowon-gu, Seoul, South Korea. Electronic address:

Introduction: Radical prostatectomy for prostate cancer has been increasingly adopted, especially for localized disease. Nevertheless, this has not been without any morbidities. Complications, such as urine leak, related to malpositioned or malfunctional indwelling catheters, are rarely reported. Read More

Ann Coloproctol 2020 Feb 5. Epub 2020 Feb 5.

Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

Purpose: Stapled anastomotic techniques to the distal rectum have gained widespread acceptance due to their procedural advantages. Various modifications in the stapling techniques have evolved since their inception. The triple-staple technique utilizing stapled closure of both the proximal colon and distal rectal stump provides a rapid and secure colorectal anastomosis. Read More

Am Fam Physician 2020 02;101(4):206-212

Mike O'Callaghan Military Medical Center, Nellis Air Force Base, NV, USA.

Evaluation and management of acute lower gastrointestinal bleeding focus on etiologies originating distally to the ligament of Treitz. Diverticular disease is the most common source, accounting for 40% of cases. Hemorrhoids, angiodysplasia, infectious colitis, and inflammatory bowel disease are other common sources. Read More