[Right-sided diverticulitis masquerading as acute appendicitis].
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Appendicitis↗
Biomedical subjects
L F Oudenhoven
Publications and source records attributed to L F Oudenhoven.
Right colonic diverticulitis: US and CT findings--new insights about frequency and natural history.
PURPOSE: To evaluate how the use of ultrasonography (US) and computed tomography (CT) has changed insights on the frequency and natural history of right colonic diverticulitis. MATERIALS AND METHODS: Clinical findings, US and CT images, and clinical and surgical records in 44 patients with a final diagnosis of right colonic diverticulitis seen over 11 years were retrospectively studied. RESULTS: Of the 44 patients, three underwent diverticulectomy, and 41 were successfully treated conservatively. Follow-up US demonstrated a consistent change in the pattern of the findings of diverticulitis over time, with eventual spontaneous evacuation of the contents of the inflamed diverticulum into the colonic lumen. Five patients had recurrent symptoms; two of them underwent elective surgery. The frequency of right colonic diverticulitis was one in 34 appendectomies, which is nine times higher than that reported to date. CONCLUSION: Right colonic diverticulitis is more common than has been previously reported. US and CT findings are characteristic and show a consistent pattern of changes over time. The natural history is benign, and surgical intervention can be avoided in the vast majority of patients.
Abdomen, Acute↗
Impaired homocysteine metabolism: a risk factor in young adults with atherosclerotic arterial occlusive disease of the leg.
To assess the prevalence of impaired homocysteine metabolism in young adults with arterial occlusive disease, 80 consecutive patients under 45 years old were screened. Various laboratory blood investigations and a standardized methionine loading test were performed. In the first 52 patients plasma levels of free homocysteine were determined; thereafter the levels of total homocysteine (a more sensitive measure of impaired homocysteine metabolism) were measured. The methionine loading test was abnormal in 15 patients (19 per cent) who did not differ from the other 65 with respect to prevalence of other risk factors, clinical characteristics, and electrocardiographic and angiographic findings. Blood levels of glucose, vitamins B6 and B12, folate, protein C and protein S, fibrinogen and low-density lipoprotein cholesterol did not differ significantly between the two groups. The prevalence of impaired homocysteine metabolism in young patients with arterial occlusive disease is greater than the 1-2 per cent found in the normal population.
Adult↗
Magnetic resonance, a new method for measuring blood flow in hemodialysis fistulae.
Blood flow through arteriovenous fistulae in patients undergoing hemodialysis needs to be within a certain range for optimal management. Magnetic resonance (MR) velocity mapping is a new modality that allows the noninvasive measurement of blood flow volume. This technique was applied in 13 patients with either a Brescia-Cimino shunt (N = 6) or a Polytetrafluoroethylene graft (Goretex, N = 7). Fistula flow volume measured by MR velocity mapping was 1386 +/- 411 ml/min (mean +/- SD, range 644 to 1921 ml/min). Interstudy reproducibility of MR velocity mapping was good (r = 0.94). Interstudy reproducibility of MR velocity mapping was good (r = 0.94). MR velocity mapping derived flow volumes showed good correlation with values obtained with an indicator dilution technique using Indocyanine Green (ICG) which was performed simultaneously in eight patients (r = 0.86). We conclude that MR velocity mapping is an accurate noninvasive method to quantify flow volume through arteriovenous fistulae in patients requiring hemodialysis.
Adult↗
Percutaneous decompression of an iliopsoas hematoma.
Spontaneous hematoma in the iliopsoas muscle is a serious complication of anticoagulant therapy. It causes severe pain and often results in loss of function of the femoral nerve. We present two cases in which percutaneous decompression of the hematoma was successfully performed to relieve intractable pain and to support functional restoration of the femoral nerve.
Aged↗