Diverticular disease of the small intestine is rare, especially when it is located in the jejunum. It is generally asymptomatic, but in some patients it may have complications such as acute diverticulitis with peritonitis, gastrointestinal bleeding or obstruction. In such cases, the recommended treatment is surgery. We report a 77-year-old patient with ileal Crohns disease with a long-standing inflammatory phenotype, who developed acute diverticulitis of the jejunum presenting a severe septic shock and secondary multiple-organ failure. It resolved with medical treatment and prolonged antibiotic therapy.
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http://dx.doi.org/10.4067/S0034-98872017000300016 | DOI Listing |
J Clin Med
December 2024
UOC Chirurgia d'Urgenza e del Trauma, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Acute diverticulitis (AD), an inflammatory complication of diverticulosis, affects around 4% of individuals with diverticulosis, with increased incidence in older populations. This study aims to assess the impact of sarcopenia, the age-related loss of muscle mass, on the clinical decision-making and outcomes of patients with AD. A retrospective study was conducted on 237 patients admitted to the Emergency Department (ED) between January 2014 and February 2022.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2024
Diagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
: To evaluate the non-inferiority of non-contrast CT compared to contrast-enhanced CT with both intravenous and rectal contrast application for the diagnosis of acute colonic diverticulitis. : Five readers retrospectively evaluated the non-contrast and contrast-enhanced series of CTs of 205 consecutive patients with clinical suspicion of acute diverticulitis. Two randomized reading sessions, both containing all 205 cases as either contrast-enhanced or non-contrast (1:1) series, were performed with ≥8 weeks washout between them.
View Article and Find Full Text PDFAntibiotics (Basel)
December 2024
Department of Microbiology, "Cantacuzino" Institute, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Antimicrobial resistance is one of the main threats to public health, with multidrug-resistant (MDR) pathogens on the rise across continents. Although treatment guidelines generally recommend antimicrobial therapy for acute complicated diverticulitis, they do not specify treatment pathways according to local or national resistance profiles. There is sparse data regarding specific pathogens involved in Hinchey II-IV patients who undergo surgery.
View Article and Find Full Text PDFAm J Emerg Med
December 2024
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:
Background: Recent studies have validated the efficacy of point-of-care ultrasound (POCUS) as an alternative diagnostic imaging approach to computed tomography (CT) for patients with suspected acute diverticulitis. This study aimed to quantify the national impact of this approach in cost savings, ED length-of-stay (LOS), and radiation risk mitigation using a POCUS-first approach for acute diverticulitis in the emergency department (ED).
Methods: Using published data, we constructed a Monte Carlo simulation model to compare two POCUS-first strategies (nonselective and selective approaches) for evaluating patients with suspected acute diverticulitis in the ED.
Biosci Microbiota Food Health
September 2024
Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
Why patients with symptomatic uncomplicated diverticular disease (SUDD) may develop acute diverticulitis (AD) is still unknown. We analyzed the gut microbiota (GM) in two SUDD patients, one who did experience SUDD recurrence but not AD occurrence (case 1) and one who did experience AD occurrence during follow-up (case 2). The GM of these patients showed differences in terms of phyla (Firmicutes and Bacteroidota in case 1; Actinobacteriota and Proteobacteria in case 2) and subgenera ( and in case 1 and , , , , group, and in case 2).
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