A 41-year-old heterosexual African man was evaluated for persistent urethral discharge, pneumaturia and watery diarrhea. Radiographic and endoscopic procedures established the diagnosis of a rectourethral fistula. The differential diagnosis of an acquired rectourethral fistula and the significance of AIDS are discussed.
Acquired Immunodeficiency Syndrome/*complications ; Adult ; Case Report ; Diverticulum/*complications/diagnosis ; Human ; Male ; Rectal Fistula/*complications/diagnosis ; Urethral Diseases/*complications/diagnosis

Adolescent ; Diagnosis, Differential ; Diverticulum, Stomach ; complications ; diagnosis ; pathology ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; pathology ; Gastroscopy ; Humans ; Male

Small bowel diverticulosis is a rare finding within all bowel diverticuloses and jejunal diverticulosis is even rarer. Their relative clinical rarity and varied presentation may make diagnosis both delayed and difficult. We experienced a case of jejunal diverticulosis, which was diagnosed intraoperatively. A 55-year-old woman was admitted to Emergency Department with pneumoperitoneum on plain chest and abdominal film from a local clinic. She was hemodynamically stable with minimal tenderness on the left upper quadrant of the abdomen but no rebound tenderness. At surgery, small bowel torsion and jejunal diverticulosis were confirmed. Over 30 variable sized small bowel diverticula were noted on the mesenteric side of the proximal jejunum. The affected segment of the jejunum was about 180 cm. On exploration, we could not find any perforation site. No postoperative complications were observed, and the patient made a full recovery. Jejunal diverticulosis is rare, but it should not be regarded as insignificant.
Abdomen ; Diagnosis ; Diverticulum* ; Emergency Service, Hospital ; Female ; Humans ; Jejunum ; Middle Aged ; Pneumoperitoneum* ; Postoperative Complications ; Thorax

Adult ; Diverticulum ; complications ; Echocardiography ; methods ; Heart Diseases ; diagnosis ; Heart Ventricles ; pathology ; Humans ; Male ; Young Adult

PURPOSE: Colon diverticula has continuously increased in Korea. This study is to identify the changes in the developmental patterns of colon diverticula and in the methods of treatment. RESULTS: A total of 66 patients who were diagnosed colon diverticular disease and hospitalized at Red Cross Hospital from April 1994 to March 2005 were enrolled. This retrospective assessment was performed by analyzing the hospital records of clinical characteristics such as demographics (age, sex), physical findings, distribution of diverticula, diagnosis methods, applicable treatments depending on severity and the stage of the disease, and complications and recurrences with whether the patient underwent a emergency or an elective operation. RESULTS: The median age was 51.8 years, with 37 males and 29 females. Of the 66 cases, right-side colon diverticula was found in 47 cases, and left side in 15 cases. Transverse and descending colon diverticula occurred concurrently in 2 cases, with 2 entire colon cases. The median number of diverticula per patient was 4.6. Of the 29 operation cases, a right colectomy was done in 10 along with 6 appendectomy and diverticulectomy cases. Postoperative complications occurred in 7 patients, of these 6 occurred in patients who had undergone an emergency operation, and 1 in a patients who had undergone an elective operation; 6 in right colon diverticular disease, and 1 in left color diverticular disease. CONCLUSIONS: Colon diverticular disease has increased with noticeable increases in left side and both-sides diseases. A one-stage operation is mainly performed for surgical treatment while fewer undergo a two-stage operation. Post-operative complications occurred in 7 cases. Exact preoperative diagnosis and an elective operation that allows bowel preparation are regarded as more crucial factors than the extension of the operation in decreasing the developmental rate and the severity of postoperative complications.
Appendectomy ; Colectomy ; Colon* ; Colon, Descending ; Demography ; Diagnosis ; Diverticulum ; Diverticulum, Colon ; Emergencies ; Female ; Hospital Records ; Humans ; Korea ; Male ; Postoperative Complications ; Recurrence ; Red Cross ; Retrospective Studies

No abstract available.
Humans ; Intestinal Obstruction/*diagnosis/etiology/surgery ; Male ; Meckel Diverticulum/complications/*diagnosis ; Middle Aged ; Radiography, Abdominal ; Tomography, X-Ray Computed

Meckel's diverticulum is an embryonic derivative of the omphalomesenteric duct and the most commonly encountered congenital anomaly of the gastrointestinal tract. Its incidence records about 2%. Among them, only 5% are symptomatic with complications-bleeding, intestinal obstruction, inflammation, and perforation. In particular, bleeding is a common complication and has always been caused by an ulceration of the ileal mucosa adjacent to the acid-producing ectopic mucosa in a Meckel's diverticulum. Wireless capsule endoscopy is a new method enabling non-invasive diagnostic endoscopy of the entire small intestine. We experienced a case of Meckel's diverticulum detected by wireless capsule endoscopy in a 34 year-old man who presented with chronic obscure gastrointestinal bleeding.
Adult ; Chronic Disease ; *Endoscopy, Gastrointestinal ; English Abstract ; Gastrointestinal Hemorrhage/*diagnosis/*etiology ; Humans ; Male ; Meckel Diverticulum/*complications/diagnosis

Duodenal diverticula are common, but perforated duodenal diverticulum is rare. Because of the disease rarity, there is no standard management protocol for perforated duodenal diverticulum. To properly manage this rare complication, a clear preoperative diagnosis and clinical disease severity assessment are important. An abdomino-pelvic CT is an unquestionably crucial diagnostic tool. Perforation is considered a surgical emergency, although conservative treatment based on fasting and broad-spectrum antibiotics may be offered in some selected cases. Herein, we report two cases of perforated duodenal diverticulum, one case managed with surgical treatment and one with conservative treatment.
Aged ; Diverticulum/complications/*diagnosis/surgery ; Duodenal Diseases/complications/*diagnosis/surgery ; Endoscopy, Digestive System ; Humans ; Intestinal Perforation/*diagnosis/etiology/surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed

The major complications of Meckel's diverticulum(MD) are bleeding, intestinal obstruction, infection, umbilical fistula and perforation. Although the relative incidences vary between authors, bleeding is the most common complication in children. The aim of our study is to show the symptomatic guideline for the diagnosis of the bleeding MD. Eight cases with bleeding MD which were operated upon at the department of Pediatric Surgery, Yeungnam University Hospital from April 1985 to April 2001 were reviewed. Half of the patients were under 2 years of age and all patients were male. All patients were preoperatively diagnosed by previous history of intestinal bleeding (melena, hematochezia) and 99mTc pertechnetate MD scan. Segmental resection and end-to-end anastomosis was performed in 6 patients and diverticulectomy in 2 patients. Heterotropic gastric mucosa was found in 6 patients. Postoperative complication was not observed in any cases. In conclusion, in any male children with obscure intestinal bleeding, especially less than 2 years of age, bleeding MD must be suspected. It seems to us that 99mTc pertechnetate MD scan is a useful tool to diagnose bleeding MD.
Child ; Diagnosis* ; Fistula ; Gastric Mucosa ; Hemorrhage* ; Humans ; Incidence ; Intestinal Obstruction ; Male ; Meckel Diverticulum* ; Postoperative Complications ; Sodium Pertechnetate Tc 99m

BACKGROUND/AIMS: Although a few published studies have reported on the relationship between diverticulosis and neoplasia in the west, it is not yet examined in Korea. The aim of this study was to determine whether there is an association between diverticulosis and colonic neoplasia. METHODS: We retrospectely analysed the medical records of 3,007 patients (M:F=1.3:1) who underwent colonoscopic examinations from year 2002 to year 2004. Patients who had a history of previous polypectomy, colon resection, or inflammatory bowel diseases were excluded. The size, extent (none, few, or many), and location of diverticuli and polyps were analyzed. RESULTS: Of 2,377 patients, included 57% were male and the mean age was 50.8 year-old. Nine percent of the patient had diverticulosis, 29% had more than one neoplasm, and 6% had advanced neoplasia. Patients with diverticular diseases had higher risks of any neoplasia than those without diverticulum (p=0.03, 37.7% vs. 28.2%). There was no correlation between diverticular diseases and advanced neoplasia. Patients with proximal diverticular diseases had higher risk of any proximal neoplasia than other patients (p<0.01 24.6% vs. 14.3%). Moreover, they had higher risk of proximal advanced neoplasia than others (p=0.01, 4.5% vs. 2%). In addition, comparison of multiple diverticular disease with few or no diverticuli revealed no difference in the risk of any neoplasia. CONCLUSIONS: These data show that the patients with diverticular diseases have more neoplasms than controls without diverticula.
Adult ; Aged ; Colonic Neoplasms/*complications/diagnosis/epidemiology ; Diverticulosis, Colonic/*complications/diagnosis/epidemiology ; Diverticulum, Colon/epidemiology/etiology ; Female ; Humans ; Korea ; Male ; Middle Aged ; Prevalence ; Retrospective Studies