Right colonic diverticulitis (RCD) and left colonic diverticulitis (LCD) may have different clinical features due to the different embryologic origins and anatomical locations of each colon. Therefore, we aimed to compare RCD and LCD in terms of the associated clinical features. We retrospectively collected clinical data from patients who were diagnosed with acute colonic diverticulitis based on computed tomography findings between 2011 and 2017. RCD was defined as colonic diverticulitis extending from the caecum to the transverse colon, and LCD was defined as extending from the splenic flexure to the sigmoid colon. These analyses included 667 patients with RCD and 58 patients with LCD. Relative to the patients with LCD, the patients with RCD were younger (P < 0.001), were more likely to be male (P = 0.033), were taller (P < 0.001), had lower body mass index values (P < 0.001), had less advanced modified Hinchey stages (P < 0.001), and had shorter hospital stays (P < 0.001). Having LCD rather than RCD was a predictor of recurrent colonic diverticulitis (P = 0.003). Relative to LCD, RCD occurs at younger ages, is expressed at less advanced modified Hinchey stages, and is associated with lower risks of recurrence. The clinical importance of colonic diverticulitis has been emphasised in the literature because the incidence of colonic diverticulitis has been increasing worldwide 1. Several studies have been conducted to evaluate left colonic diverticulitis (LCD) and identify the best treatment strategy because it is common in Western populations 2,3. In contrast, right colonic diverticulitis (RCD) is rare in Western populations but common in Asian populations 4,5. Despite its prevalence in Asian populations, few studies have investigated the clinical course of RCD or sought to identify the best treatment strategy. Recently, Strate et al. 6 introduced a management algorithm for colonic diverticulitis that was mainly based on LCD. As a result, the algorithm has limited applicability to patients with RCD. For example, the algorithm recommends that only patients with complicated diverticulitis undergo surgery. It further recommends that if surgery is performed, then second-stage surgery should also be performed depending on the patient's hemodynamic stability. However, the medical literature contains few cases of RCD in Asian patients for whom complicated diverticulitis was an indication for surgery 7. The left and right colons have different embryologic origins, with the left colon originating from the hindgut and the right colon originating from the midgut 8. Right diverticular disease and left diverticular disease differ in that diverticula from the left colon are more likely to be true diverticula 8. Therefore, the clinical characteristics of LCD and RCD may differ. Thus far, a few studies have compared RCD and LCD, but these studies have been severely limited by their small sample sizes 9,10. We therefore aimed to perform a similar study with a larger sample size. Methods This study was approved by the institutional...
An inflammatory myofibroblastic tumor (IMT) is a solid tumor of unknown etiology frequently affecting children and young adults and commonly affecting the lung or orbital region. We present a case involving a 41-year-old man who had an IMT combined with Mycobacterium tuberculosis infection in the retroperitoneum. He presented with only pain in the right lower abdomen without accompanying symptoms; a retroperitoneal mass was found on computed tomography. The tumor had invaded the end of the ileum and was attached to the omentum, so mass excision could not be performed. The tumor was completely excised surgically and had histological features diagnostic of an IMT. Histologic findings of the omentum were positive for Ziehl-Nielsen staining for acid-fast bacilli and for a positive polymerase chain reaction for M. tuberculosis. The patient had no apparent immune disorder. These findings made this case exceptional because IMTs, which are mostly due to atypical mycobacteria, have been found mainly in immunocompromised patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.