Diverticulitis aguda complicada: tendencias en el tratamiento actual

C, Nicolás Pereira; S, Javier Vega; Readi, Alejandro; M, Mario Abedrapo; G, Alfonso Galleguillos

doi:10.4067/s0718-40262012000600015

Cited by 2 publications

(4 citation statements)

References 39 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…La posible evolución espontánea -o incluso con tratamiento antibiótico -están contempladas en la clasiicación de Hinchey (1) . La contaminación del retroperitoneo secundaria a una perforación diverticular es mencionada escasamente en la literatura médica (2,3) ; el retroneumoperitoneo comprobado ante cuadros sépticos de causa no determinada -como lo fue al inicio en ambos casos reportados -señala en general un cuadro grave, habida cuenta de la perforación segura de alguna parte del tracto gastrointestinal. Finalmente, la comprobación de un neumomediastino asociado -como ocurrió en uno de los casos presentados -plantea interrogantes adicionales ante la posibilidad de una perforación esofágica, extremadamente grave (4) .…”

Section: Discussionunclassified

Pneumoretroperitoneum and Retroperitoneal Cellulitis: Unusual Complications of Colonic Diverticular Disease

Samaniego¹,

Rodriguez²,

Rojas³

et al. 2016

Rev. Cir. Parag

View full text Add to dashboard Cite

RESUMENSe reporta dos casos de retroneumoperitoneo con neumomediastino, consecuencias de perforaciones diverticulares en el espacio retroperitoneal, en pacientes portadores de diverticulitis aguda y septicemia. En ambos casos no se comprobó contaminación peritoneal alguna, siendo sometidos a Colectomia parcial tipo Hartmann con buena evolución; al momento del reporte ambos han sido sometidos al restablecimiento del tránsito colo-rectal. Se discuten los problemas diagnósticos y los posibles mecanismos del paso del aire -y gérmenes bacterianos -al mediastino.Palabras clave: retroneumoperitoneo, diverticulitis. ABSTRACTWe report two cases of retropneumoperitoneum with pneumomediastinum, as a result of diverticular perforations in the retroperitoneal space, in patients with acute diverticulitis and septicemia. In both cases the patients underwent partial colectomy (Hartmann procedure) with good evolution, and no sign of peritoneal contamination was found. Currently both patients have undergone colorectal transit restoration. We discuss problems with the diagnosis and possible mechanism of the air and bacterial germ passage to the mediastinum.

show abstract

Section: Discussionunclassified

Pneumoretroperitoneum and Retroperitoneal Cellulitis: Unusual Complications of Colonic Diverticular Disease

Samaniego¹,

Rodriguez²,

Rojas³

et al. 2016

Rev. Cir. Parag

View full text Add to dashboard Cite

show abstract

“…There are reports describing an inguinal approach and inguinal mesh plasty within the same surgical procedure, with several reports addressing that meshes can be used in contaminated surgical areas [5,6]. Hartman procedure comes with high mortality and high rates of surgical site infection, up to 25%, but it is still highly recommended by several authors [7,8]. About colon diverticulum, defined as a mucosa protrusion through weak zones, that only contain a layer of mucosa and submucosa, some authors consider the term "pseudo diverticulum" more accurate.…”

Section: Literature Reviewmentioning

confidence: 99%

“…About colon diverticulum, defined as a mucosa protrusion through weak zones, that only contain a layer of mucosa and submucosa, some authors consider the term "pseudo diverticulum" more accurate. Colon diverticulum are most frequent at the sigmoid colon, 65-95%, and have an acute diverticulitis presentation in about 25% of patients, being the most frequent complication, requiring in 30% of cases an emergency surgical approach due to peritonitis or sepsis [7].…”

Section: Literature Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Left Inguinal Hernia, Sigmoid Diverticulum and a Probable B4 Type Duplicated Appendix

Bizueto-Rosas¹,

Na²,

Nn³

et al. 2019

J Surg Open Access

View full text Add to dashboard Cite

Objective: We present a case report of an 89 years old male with a diagnosis of incarcerated left inguinal hernia, with surgical findings of a complicated sigmoid diverticulum and a tubular structure of 0.5 mm attached to the sigmoid colon, fixed to the inguinal ligament with a true lumen that could correspond to a duplicated appendix B4 type. Introduction: Colon diverticular disease is more frequent in western countries, present in 30% of 60 years old patients and in more than 50% in 80 years old patients, with 95% of the times located at sigmoid colon. The most frequent complication is the acute diverticulitis (25%) and in 30% of these patients, surgery is required. Discussion: Acute, complicated, diverticular disease is an infrequent pathology, even more, a colonic diverticulum included within the hernia sac. Of the appendix congenital malformations, a duplicated appendix is the rarest; usually found in asymptomatic adults as an incidental find during abdominal surgery or during contrasted abdominal scans. Conclusion:Awareness must be raised within first-contact health care professionals about diagnosing surgical entities with high mortality rates, in asymptomatic patients with unclear clinical findings, especially with the occurring of a demographic transition in most countries. In this specific patient, Hartman surgical procedure and a second time inguinal plasty were the best surgical options for this patient; even considering the mortality rates (25%) of a perforated diverticulum, considering added surgical site infection.

show abstract

Diverticulitis aguda complicada: tendencias en el tratamiento actual

Cited by 2 publications

References 39 publications

Pneumoretroperitoneum and Retroperitoneal Cellulitis: Unusual Complications of Colonic Diverticular Disease

Pneumoretroperitoneum and Retroperitoneal Cellulitis: Unusual Complications of Colonic Diverticular Disease

Left Inguinal Hernia, Sigmoid Diverticulum and a Probable B4 Type Duplicated Appendix

Contact Info

Product

Resources

About