Cysts ; diagnosis ; surgery ; Female ; Humans ; Infant ; Intestinal Diseases ; diagnosis ; surgery ; Meckel Diverticulum ; diagnosis

Stercoral perforation of the colon is an unusual pathological condition with fewer than 150 cases reported in the literature to date. We present a case of stercoral colonic perforation mimicking upper gastrointestinal perforation, which was diagnosed by computed tomography preoperatively. However, at laparotomy, stercoral colonic diverticulum perforation with jejunal diverticulitis became the most appropriate diagnosis.
Aged, 80 and over ; Colonic Diseases ; diagnosis ; surgery ; Diverticulitis ; diagnosis ; surgery ; Diverticulum, Colon ; diagnosis ; surgery ; Humans ; Intestinal Perforation ; diagnosis ; surgery ; Jejunal Diseases ; diagnosis ; Male ; Tomography, X-Ray Computed

No abstract available.
Adult ; Female ; Humans ; Meckel Diverticulum/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed ; Torsion Abnormality

To evaluate the ultrasound imaging characteristics and diagnostic criteria for acute abdominal Meckel's di- verticulum disease (MD), we retrospectively analyzed the ultrasonic characteristics, clinical data of 58 cases of pathologically proved MD from January 2009 to May 2012. We found that among all the 58 patients, 21 patients were diagnosed with the preoperative clinical diagnosis of MD. Fourteen cases of MD inflammation with acute appendicitis were evaluated by pathological examinations after the surgery. We also found 4 cases of MD with perforation, 15 cases of MD with intussusceptions, 14 cases MD with intestinal obstruction, 5 cases of MD secondary to intestinal obstructionor intestinal necrosis, and 5 cases of MD without any obvious complications. Emergency ultrasound examinations revealed 8 cases of simple MD, 1 case of MD with intussusceptions, 9 cases of MD with acute appendicitis, 12 cases of MD with intestinal obstruction, 2 cases of MD with intussusceptions and intestinal obstruction, 1 case of MD with omphalocele and 1 case of MD with abdominal abscess. The emergency sonographic findings suggested that MD was relatively fixed bowel or thick-walled cystic mass, with one end connected to small intestine, and the other end connected to the blind side, at the periumbilicus region or at the lower right abdomen. A conclusion could be drawn that MD is difficult to be detected by ultrasound (detection rate was about 15. 5%), and MD with complications such as intussusceptions, intestinal obstruction, acute appendicitis can usually be more easily detected (detection rates were 24.1%, 24.1% and 15.5%, respectively). Sonography is a simple, effective way to make diagnosis and differential diagnosis of MD with different acute abdomen symptoms from other disease.
Acute Disease ; Appendicitis ; pathology ; Diagnosis, Differential ; Humans ; Inflammation ; Intestine, Small ; pathology ; surgery ; Meckel Diverticulum ; diagnostic imaging ; surgery ; Retrospective Studies ; Ultrasonography

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

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 the most common anomaly of the intestine. It is usually asymptomatic but approximately 4% are symptomatic with complications such as bleeding, intestinal obstruction, and inflammation. Gastrointestinal bleeding is the most common presenting symptoms of Meckel's diverticulum in children, however, intestinal obstruction is the most common complications in adult patients. Reported mechanism of intestinal obstruction in Meckel's diverticulum include intussusception, adhesion, and volvulus. Recently, we experienced a case with Meckel's diverticulum associated with ileal stricture causing recurrent partial intestinal obstruction in a 48-year-old man. In contrast to other published cases of small bowel obstruction in Meckel's diverticulum, this case was caused by ileal stricture associated with Meckel's diverticulum.
Endoscopy, Gastrointestinal ; Humans ; Ileal Diseases/*diagnosis/*etiology/surgery ; Intestinal Obstruction/*diagnosis/etiology/surgery ; Male ; Meckel Diverticulum/*complications/pathology/surgery ; Middle Aged ; Recurrence

BACKGROUND/AIMS: Small bowel diverticulum is a rare disease that can be found incidentally during a surgical operation. Since reported complication rate is low, uncomplicated small bowel diverticula are generally recommended to be untreated. The aim of this study was to elucidate clinical features of this disease and to determine whether incidental small bowel diverticula should be removed for cure. METHODS: We reviewed the medical records of 80 patients with small bowel diverticular disease who underwent operation at Asan Medical Center between July 1989 and March 2003, retrospectively. RESULTS: Male to female ratio was 61:19, and the mean age was 44 (0-91) years. The most common diverticulum of small bowel is Meckel's diverticulum (63.8%), followed by duodenal diverticulum (15%), jejunal diverticulum (12.5%), and ileal diverticulum (8.7%). Of the 80 cases, 43 (53.7%) were symptomatic, and 37 (46.3%) were incidental. In the symptomatic patients, the most frequent symptom was abdominal pain (58.1%), followed by bleeding (44.2%). As for the treatments, segmental resection (53.7%) was performed more commonly than diverticulectomy (43.8%) in the symptomatic patients. Postoperative complications occurred more commonly in the symptomatic patients (25.6%) than the incidental patients (8.1%). Duodenal diverticula had a high morbidity and mortality rate. CONCLUSIONS: We should consider the diverticular disease of small bowel in patients with unexplained abdominal pain or gastrointestinal bleeding. As most small bowel diverticula, except for duodenal diverticula, are found incidentally and easily removed without postoperative morbidity or mortality, surgical resection appears to be recommended for the purpose of accurate diagnosis and treatment.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Diverticulum/diagnosis/*surgery ; English Abstract ; Female ; Humans ; Infant ; Infant, Newborn ; Intestinal Diseases/diagnosis/*surgery ; Intestine, Small/*surgery ; Male ; Middle Aged

Lacrimal sac diverticulum is a rare condition, and its various symptoms complicate differential diagnosis. We present cases of a peculiar type of lacrimal diverticulum. A 5-year-old girl and a 50-year-old woman presented with a protruding mass inferior to the medial canthus. Each lacrimal system was patent to irrigation. The masses compressed and distorted the lacrimal passage and had no apparent connection with the lacrimal sac in dacryocystography or computed tomography. Surgical exploration and complete excision of the masses were completed. Each patient had an inverted Y- and an inverted V-shaped multilobular cystic mass that was pathologically confirmed as a lacrimal sac diverticulum. Lacrimal sac diverticula may rarely take the form of a multilobular cyst and can present as a lower lid mass. We speculate that an abnormality in lacrimal embryogenesis resulted in multiple blind pouches, a peculiar type of lacrimal sac diverticulum.
Child, Preschool ; Diagnosis, Differential ; Diverticulum/radiography/*surgery ; Eyelids/radiography/surgery ; Female ; Humans ; Lacrimal Apparatus Diseases/radiography/*surgery ; Middle Aged ; Tomography, X-Ray Computed

A 68-yr-old man complaining of sudden, postprandial chest pain visited the emergency room. His symptom had been aggravated during the preceding two days. Upper gastrointestinal contrast study with gastrographin showed leakage of dye from the epiphrenic diverticulum in the lower third of the esophagus. The primary repair was urgently carried out. Upper gastrointestinal contrast study 14 days after operation revealed an esophageal leakage which was small and confined. The patient was managed with conservative treatments such as intravenous hyperali-mentation and broad-spectrum antibiotics. Forty-two days after the operation, a gastrographin swallow study showed the absence of leaks. This is the first report-ed case of a perforated epiphrenic esophageal diverticulum repaired by delayed primary repair in Korea.
Aged ; Diverticulum, Esophageal/complications/*diagnosis/*surgery ; Esophageal Perforation/*diagnosis/etiology/*surgery ; Esophagectomy/*methods ; Humans ; Male ; Research Support, Non-U.S. Gov't ; Time Factors ; Treatment Outcome