Emergency surgery for Hinchey Stage II diverticulitis carries a high mortality rate and should be avoided. To achieve this, antibiotic therapy alone seems to be a safe alternative, whenever percutaneous drainage is technically difficult or hazardous. Actually, our data did not demonstrate any benefit of CT scan-guided percutaneous abscess drainage, suggesting that the role of interventional radiology techniques in this indication deserves further critical evaluation.

Background: Percutaneous abscess drainage guided by computed tomography scan is considered the initial step in the management of patients presenting with Hinchey II diverticulitis. The rationale behind this approach is to manage the septic complication conservatively and to follow this later using elective sigmoidectomy with primary anastomosis. Methods: The clinical outcomes for Hinchey II patients who underwent percutaneous abscess drainage in our institution were reviewed. Drainage was considered a failure when signs of continuing sepsis developed, abscess or fistula recurred within 4 weeks of drainage, and emergency surgical resection with or without a colostomy had to be performed. Results: A total of 34 patients (17 men and 17 women; median age, 71 years; range, 34-90 years) were considered for analysis. The median abscess size was 6 cm (range, 3-18 cm), and the median duration of drainage was 8 days (range, 1-18 days). Drainage was considered successful for 23 patients (67%). The causes of failure for the remaining 11 patients included continuing sepsis (n = 5), abscess recurrence (n = 5), and fistula formation (n = 1). Ten patients who failed percutaneous abscess drainage underwent an emergency Hartmann procedure, with a median delay of 14 days (range, 1-65 days) between drainage and surgery. Three patients in this group (33%) died in the immediate postoperative period. Among the 23 patients successfully drained, 12 underwent elective sigmoid resection with a primary anastomosis. The median delay between drainage and surgery was 101 days (range, 40-420 days). In this group, there were no anastomotic leaks and no mortality. Conclusion: Drainage of Hinchey II diverticulitis guided by computed scan was successful in two-thirds of the cases, and 35% of the patients eventually underwent a safe elective sigmoid resection with primary anastomosis. By contrast, failure of percutaneous abscess drainage to control sepsis is associated with a high mortality rate when an emergency resection is performed. The current results demonstrate that percutaneous abscess drainage is an effective initial therapeutic approach for patients with Hinchey II diverticulitis, and that emergency surgery should be avoided whenever possible.

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The endoscopic application of intragastric balloons (IGB) is a very effective non-surgical technique in the treatment of excess body weight.The aim of this study was to аnalyze the effectiveness of IGB in obesity treatment and tо compare the results of using different types of IGB.Material and methods. The study included 80 overweight patients with a BMI between 25 and 40 kg/m 2 , treated with the application of two types of IGB (Spatz and Endd-Ball). Weight control of patients was performed 48 hours, 7 days, 14 days, 30 days, 90 days, and 180 days after the IGB placement, as well as 6 months after the IGB removal. Six months after application, the IGBs were endoscopically removed. The number of kilograms lost, as well as the change in BMI, were analyzed. A comparison between the results obtained with the two different types of IGB (Spatz and Edd-Ball) was made. For statistical processing of the data, a database was created in the statistical program SPSS for Windows, 23.0.Results. The average weight loss 6 months after the application of IGB was about 15 kg. Comparing BMI values before and 6 months after the intervention showed a statistically significant decrease in BMI after the intervention (p= 0.00) and confirmed the efficacy of IGB. Comparing the lost kilograms in relation to the type of IGB applied did not show statistically significant differences.Conclusion. The application of IGB has shown to be an effective method for weight loss.

Obesity is a complex, chronic, metabolic disease characterized by excessive accumulation of adipose tissue in the body and numerous side effects on health. Endoscopic bariatric therapy (EBT) is just one method of treating obesity. Of the many EBT devices, intragastric balloons (IGBs), which take up some space in the stomach, are the most widely used in clinical practice.The aim of this study was to demonstrate the effectiveness of the use of IGB in the treatment of obesity and to compare the results of the use of two different IGBs, Spatz and Edd-ball.The study included 30 overweight patients with BMI (body mass index) between 25 and 40 kg /m 2 , treated with IGB application. All patients were monitored for a period of 6 months from IGB placement until its removal.Number of kilograms lost 6 months after IGB application, BMI change, the presence of comorbidities before and after the intervention, complications durig the intervention and patient satisfaction with the success of the procedure were analyzed. A comparison was also made between the results obtained with the two different types of IGB (Spatz and Edd-ball).The average weight loss 6 months after IGB application was 15.3 kg. Comparison of BMI values before and 6 months after the intervention showed a statistically significant decrease in BMI after the intervention (p = 0.00). The comparison of the lost kilograms in relation to the type of IGB applied did not show a statistically significant difference between the two types of IGB used. Changes in comorbidities after the intervention did not show statistically significant differences.Despite the limitations of this study, which was performed on a small number of patients, the use of IGB has proven to be an effective method of weight loss. No serious complications or fatalities were reported during the procedure.