scholarly journals Computer tomography in diagnostics and treatment of inflammatory complications of diverticular disease of the colon

2021 ◽  
Vol 20 (4) ◽  
pp. 34-41
Author(s):  
O. Yu. Karpukhin ◽  
A. F. Yusupova ◽  
Yu. S. Pankratova ◽  
M. I. Cherkashina ◽  
A. A. Akhmadullina
Keyword(s):  
Computed Tomography ◽  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
Abdominal Mass ◽  
Diagnostic Algorithm ◽  
Diagnostic Value ◽  
Indications For Surgery ◽  
Clinical Form ◽  
Intravenous Contrast

AIM: to evaluate the role of computed tomography (CT) in the treatment and diagnostic algorithm in patients with complicated diverticular disease (CDD).PATIENTS AND METHODS: during the period from 2014 to 2020, 165 hospitalized patients with complications of CDD included in the study. Fifteen (9.1%) patients were hospitalized for elective indications and 150 (90.9%) as emergencies. The indications for hospitalization were inflammatory complications of CDD. Computed tomography with intravenous contrast was performed in 89 (53.9%) patients. The study was performed on a 64-slice CT “Philips Brilliance 64” with intravenous bolus injection of a low-osmolar iodine-containing contrast agent. The absence of the CT in the remaining patients is due to the presence of classical symptoms of acute diverticulitis with a previously verified diagnosis of CDD, the presence of an informative transabdominal ultrasound, as well as the refusal of patients from CT.RESULTS: the CT allowed to verify the presence of diverticula in the patients, to reveal the distinctive CT signs and pathognomonic symptoms of inflammatory complications of CDD, as well as to establish the severity of the complications that occurred. The specific signs of the destruction of the diverticulum and the complications developed were abdominal mass, abscess, peritonitis, and fistula. Besides the diagnostic value, CT scan permitted to choose the treatment approach and to clarify indications for surgery. Besides that, some CDD complications revealed by CT were considered as a predictor of ineffectiveness of conservative treatment, which requires surgery.CONCLUSION: CT is a valuable diagnostic method for CDD which allows to determine timely the clinical form of inflammatory complication, to find out indications for surgery and to predict high risk of recurrence.

scholarly journals Role of MSCT in the diagnosis of perforated gall bladder (a retrospective study)

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed M. Harraz ◽  
Ahmed H. Abouissa
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Gall Bladder ◽  
Acute Cholecystitis ◽  
Acute Diverticulitis ◽  
Wall Thickening ◽  
Free Fluid ◽  
Iodinated Contrast ◽  
Contrast Enhanced

Abstract Background Although gall bladder perforation (GBP) is not common, it is considered a life-threating condition, and the possibility of occurrence in cases of acute cholecystitis must be considered. The aim of this study was to assess the role of multi-slice computed tomography (MSCT) in the assessment of GBP. Results It is a retrospective study including 19 patients that had GBP out of 147, there were 11 females (57.8%) and 8 males (42.1%), aged 42 to 79 year (mean age 60) presented with acute abdomen or acute cholecystitis. All patients were examined with abdominal ultrasonography and contrast-enhanced abdominal MSCT after written informed consent was obtained from the patients. This study was between January and December 2018. Patients with contraindications to contrast-enhanced computed tomography (CT) (pregnancy, acute kidney failure, or allergy to iodinated contrast agents) who underwent US only were excluded. Patients with other diagnoses, such as acute diverticulitis of the right-sided colon or acute appendicitis, were excluded. The radiological findings were evaluated such as GB distention; stones; wall thickening, enhancement, and defect; pericholecystic free fluid or collection; enhancement of liver parenchyma; and air in the wall or lumen. All CT findings are compared with the surgical results. Our results revealed that the most important and diagnostic MSCT finding in GBP is a mural defect. Nineteen patients were proved surgically to have GBP. Conclusion GBP is a rare but very serious condition and should be diagnosed and treated as soon as possible to decrease morbidity and mortality. The most accurate diagnostic tool is the CT, MSCT findings most specific and sensitive for the detection of GBP and its complications.

scholarly journals Role of Dietary Habits in the Prevention of Diverticular Disease Complications: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1288
Author(s):  
Marilia Carabotti ◽  
Francesca Falangone ◽  
Rosario Cuomo ◽  
Bruno Annibale
Keyword(s):  
Systematic Review ◽  
Diverticular Disease ◽  
Dietary Habits ◽  
Acute Diverticulitis ◽  
High Quality ◽  
Eligibility Criteria ◽  
Diverticular Bleeding ◽  
Recurrent Diverticulitis ◽  
Increased Risk

Recent evidence showed that dietary habits play a role as risk factors for the development of diverticular complications. This systematic review aims to assess the effect of dietary habits in the prevention of diverticula complications (i.e., acute diverticulitis and diverticula bleeding) in patients with diverticula disease. PubMed and Scopus databases were searched up to 19 January 2021, 330 records were identified, and 8 articles met the eligibility criteria and were subjected to data extraction. The quality of the studies was evaluated by the Newcastle-Ottawa quality assessment form. No study meets the criteria for being a high-quality study. A high intake of fiber was associated to a decreased risk of diverticulitis or hospitalization due to diverticular disease, with a protective effect for fruits and cereal fiber, but not for vegetable fiber; whereas, a high red meat consumption and a generally Western dietary pattern were associated with an increased risk of diverticulitis. Alcohol use seemed to be associated to diverticular bleeding, but not to recurrent diverticulitis or diverticular complications. Further high-quality studies are needed to better define these associations. It is mandatory to ascertain the role of dietary habits for the development of recurrent acute diverticulitis and diverticular bleeding.

scholarly journals Gut Microbiota and Acute Diverticulitis: Role of Probiotics in Management of This Delicate Pathophysiological Balance

2021 ◽  
Vol 11 (4) ◽  
pp. 298
Author(s):  
Andrea Piccioni ◽  
Laura Franza ◽  
Mattia Brigida ◽  
Christian Zanza ◽  
Enrico Torelli ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
Bacterial Species ◽  
Mucosal Inflammation ◽  
Abdominal Symptoms ◽  
Pubmed Database ◽  
Anti Inflammatory ◽  
Key Terms

How can the knowledge of probiotics and their mechanisms of action be translated into clinical practice when treating patients with diverticular disease and acute diverticulitis? Changes in microbiota composition have been observed in patients who were developing acute diverticulitis, with a reduction of taxa with anti-inflammatory activity, such as Clostridium cluster IV, Lactobacilli and Bacteroides. Recent observations supported that a dysbiosis characterised by decreased presence of anti-inflammatory bacterial species might be linked to mucosal inflammation, and a vicious cycle results from a mucosal inflammation driving dysbiosis at the same time. An alteration in gut microbiota can lead to an altered activation of nerve fibres, and subsequent neuronal and muscular dysfunction, thus favoring abdominal symptoms’ development. The possible role of dysbiosis and mucosal inflammation in leading to dysmotility is linked, in turn, to bacterial translocation from the lumen of the diverticulum to perivisceral area. There, a possible activation of Toll-like receptors has been described, with a subsequent inflammatory reaction at the level of the perivisceral tissues. Being aware that bacterial colonisation of diverticula is involved in the pathogenesis of acute diverticulitis, the rationale for the potential role of probiotics in the treatment of this disease becomes clearer. For this review, articles were identified using the electronic PubMed database through a comprehensive search conducted by combining key terms such as “gut microbiota”, “probiotics and gut disease”, “probiotics and acute diverticulitis”, “probiotics and diverticular disease”, “probiotics mechanism of action”. However, the amount of data present on this matter is not sufficient to draw robust conclusions on the efficacy of probiotics for symptoms’ management in diverticular disease.

scholarly journals Imaging of larynx: Diagnostic value of computed tomography and magnetic resonance imaging

2009 ◽  
Vol 56 (3) ◽  
pp. 39-44
Author(s):  
R.M. Maksimovic ◽  
B.A. Banko ◽  
J.P. Milovanovic
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Regional Lymph Node ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Precise Diagnosis ◽  
Node Metastases ◽  
Magnetic Resonance Imaging Mri

Computed tomography (CT) and magnetic resonance imaging (MRI) are enabling more precise diagnosis and treatment planning in patients with diseases of the larynx. The aim of this article is to describe the role of these methods in assessment of the laringeal diseases and key local anatomic characteristics important for spread of the disease. CT and MRI have a valuable contribution to the staging of the tumors due to the possibility to show the relationship to the ventricular complex, involvement of the subumucosal spaces, defining craniocaudal and anterposterior extension, laringeal cartilage invasion, as well as regional lymph node metastases.

scholarly journals The diagnostic value of intravenous contrast computed tomography in addition to plain computed tomography in dogs with head trauma

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yasamin Vali ◽  
Ingrid Gielen ◽  
Sarang Soroori ◽  
Eberhard Ludewig
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Head Trauma ◽  
Cerebral Edema ◽  
Diagnostic Value ◽  
Intravenous Contrast ◽  
Post Contrast ◽  
Traumatic Injuries ◽  
Severity Grading ◽  
History Of

Abstract Background The aim of this study is to evaluate additional findings which can be detected by post-contrast computed tomography (CCT) in relation to plain CT (PCT) findings in patients presented with head trauma. Medical records of canine patients with the history of head trauma from three institutions were reviewed. PCT- and CCT-anonymized images were evaluated by a veterinary radiologist separately. From the categorized findings the following conclusions were drawn as: abnormalities were identified on (A) PCT but missed on CCT, (B) CCT but missed on PCT, (C) both PCT and CCT. Results Thirty-two patients were included. The results showed that findings identified on CCT or PCT (category A and B) but missed on the other series were limited to mild soft tissue and sinus changes. Overall, 61 different fracture areas, 6 injuries of the temporomandibular joint (TMJ), 4 orbital injuries, 14 nasal cavities with soft tissue density filling, 13 areas of emphysema, 4 symphysis separations, 12 intracranial hemorrhages, 6 cerebral edema, 5 cerebral midline shifts, 3 intracranial aeroceles, 3 brain herniations and 6 intraparenchymal foreign bodies (defined as an abnormal structure located within the brain: e.g. bony fragments, bullet, teeth,..) were identified on both PCT and CCT separately (category C). Severity grading was different in 50% (3/6) of the reported cerebral edema using PCT and CCT images. Conclusion The results showed that PCT is valuable to identify the presence of intracranial traumatic injuries and CCT is not always essential to evaluate vital traumatic changes.

scholarly journals Role of Inflammation in the Pathogenesis of Diverticular Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Antonio Tursi ◽  
Walter Elisei
Keyword(s):  
Diverticular Disease ◽  
Acute Diverticulitis ◽  
Human Colon ◽  
Recurrent Abdominal Pain ◽  
Preliminary Evidence ◽  
Low Grade ◽  
Symptom Persistence ◽  
Uncomplicated Diverticular Disease ◽  
Low Grade Inflammation

Diverticulosis of the colon is the most common condition in Western societies and it is the most common anatomic alteration of the human colon. Recurrent abdominal pain is experienced by about 20% of patients with diverticulosis, but the pathophysiologic mechanisms of its occurrence are not completely understood. In the last years, several fine papers have showed clearly the role of low-grade inflammation both in the occurrence of symptoms in people having diverticulosis, both in symptom persistence following acute diverticulitis, even if the evidence available is not so strong. We do not know yet what the trigger of this low-grade inflammation occurrence is. However, some preliminary evidence found colonic dysbiosis linked to low-grade inflammation and therefore to symptom occurrence in those patients. The aim of this paper is to summarize current evidences about the role of inflammation in symptom occurrence in symptomatic uncomplicated diverticular disease and in symptom persistence after an episode of acute diverticulitis.

scholarly journals Computed Tomography With Intravenous Contrast Alone: The Role of Intra-abdominal Fat on the Ability to Visualize the Normal Appendix in Children

2013 ◽  
Vol 20 (8) ◽  
pp. 795-800 ◽  
Author(s):  
Madelyn Garcia ◽  
George Taylor ◽  
Lynn Babcock ◽  
Jonathan R. Dillman ◽  
Vaseem Iqbal ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Fat ◽  
Normal Appendix ◽  
Intravenous Contrast

scholarly journals Multislice Computed Tomography Imaging of Diverticultis Complication: Colovenous Fistula

2010 ◽  
Vol 10 (2) ◽  
pp. 118-120
Author(s):  
Maija Radzina ◽  
Andris Laganovskis ◽  
Mara Tirane ◽  
Ligita Zvaigzne ◽  
Peteris Prieditis ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diverticular Disease ◽  
Multislice Computed Tomography ◽  
Gastrointestinal Disease ◽  
Rare Complication ◽  
Acute Diverticulitis ◽  
Computed Tomography Imaging ◽  
Tomography Imaging ◽  
Complicated Form ◽  
Radiological Studies

Multislice Computed Tomography Imaging of Diverticultis Complication: Colovenous FistulaAcute colon pathology as diverticulitis is a frequent and important gastrointestinal disease, but the clinical diagnosis is often difficult to state. Several radiological studies have been used to assist in the diagnosis of acute diverticulitis (e.g. barium enema, ultrasound, and computed tomography (CT). Colovenous fistula is a rare complication of diverticulitis. We have analyzed MSCT imaging role in evaluation of such complicated form of diverticular disease.

scholarly journals Colonoscopy and flexible sigmoidoscopy for follow-up of patients with left-sided diverticulitis

2020 ◽  
Vol 102 (9) ◽  
pp. 744-747
Author(s):  
Z Abdulazeez ◽  
N Kukreja ◽  
N Qureshi ◽  
S Lascelles
Keyword(s):  
Computed Tomography ◽  
Diverticular Disease ◽  
Flexible Sigmoidoscopy ◽  
Health Care Systems ◽  
Acute Diverticulitis ◽  
Western World ◽  
Routine Surveillance ◽  
New Findings ◽  
Care Systems

Introduction The prevalence of diverticular disease has been increasing in the western world over the last few decades, causing a growing burden on health care systems. This study compared the uses of flexible sigmoidoscopy with colonoscopy as a follow-up investigation for patients diagnosed with acute left-sided diverticulitis and to evaluate the need for using either procedure. Materials and methods A retrospective study of 327 patients diagnosed with acute diverticulitis was carried out. Of this total, 240 patients with left-sided diverticulitis diagnosed via computed tomography were included. These patients were categorised into two equal groups: the first 120 patients underwent colonoscopy and the second 120 patients underwent flexible sigmoidoscopy. Results All colonoscopes and flexible sigmoidoscopes confirmed the computed tomography diagnosis of sigmoid diverticular disease with no major new findings. All colonoscopes and flexible sigmoidoscopes were reported as having no complications, with nine colonoscopes reported as being difficult compared with only three flexible sigmoidoscopes. All biopsies were reported as no malignancy. Full bowel preparation was required in all colonoscopes, compared with no preparation required for flexible sigmoidoscopes. Conclusions There is no evidence to support the routine use of endoscopic evaluation after an episode of left-sided diverticulitis diagnosed on computed tomography if no worrying radiological findings have been reported. This study supports similar findings from other studies and therefore we disagree with The Royal College of Surgeons of England (Association of Coloproctology of Great Britain and Ireland recommendations) commissioning guide, which advocates routine surveillance of the colon.

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