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PubMedDate not supplied

[Radiological aspects of peri-diverticular disease of the colon. An anatomo-pathological correlation (author's transl].

Sixty consecutive cases operated for diverticular disease of the colon within the last 10 years are reviewed. A comparative study is made of the anatomopathological examination of the specimens and their radiological aspect trying to establish the precise radiological picture of acute, chronic and fibrotic peri-diverticular disease. Plain films of the abdomen, intravenous uro- and cystography are very useful in acute cases. A baryum enema just prior to surgery (33 cases) heralds by the rigid aspect of the involved bowelsegment the acute case; spasms, thick disorderly folds and localized extravasation characterize the acute peridiverticulitis. Fibrotic peri-diverticular disease shows disorderly, fine but "ragged" folds associated with extrinsic fistulae. In many cases the inflammation is not purely acute nor chronic or fibrotic. The distinguishing histological types are simultaneously present and render the radiological picture complex.

Barium Sulfate↗
PubMedDate not supplied

The role of colonoscopy in complicated diverticular disease. A review.

Colonoscopy in complicated diverticular disease may assist the clinician in establishing the diagnosis of associated strictures. A review of the literature shows that carcinoma was identified in 21 (17%) of 125 patients and that an additional diagnosis was made in 40 (32%) patients. Although colonoscopy may be a difficult procedure in patients with diverticular disease the caecum was reached in 27 (61%) of 44 patients and took no longer than routine colonoscopic orpcedures. Further analysis of these results confirms that the barium enema frequently produces both false positive and false negative diagnoses of carcinoma and polyps. The presence of bleeding strongly suggests the presence of a concomitant lesion. Fifteen (11%) carcinomas were identified in a group of 135 patients with persistent rectal bleeding whose barium enema showed only diverticular disease and an additional diagnosis was made in 50 (37%) of these patients. Colonoscopy is an important investigation in patients with complicated diverticular disease.

Aged↗
PubMedDate not supplied

Value of colonoscopy in the detection of sigmoid malignancy in patients with diverticular disease.

Sixty patients with diverticular disease, referred because a barium enema examination could not exclude a co-existing malignanty, were studied in a retrospective manner, to find out the contribution of colonoscopy in the diagnosis of sigmoid carcinoma in such patients. All X-ray studies were blindly reviewed and divided in two categories: a) diverticular disease with malignancy or strong suspicion for malignancy and b) diverticular disease without suspicion for malignancy. The accuracy of the endoscopical examination was evaluated by a follow-up study with a range of 3 months-3 years. Colonoscopy appeared to be accurate in more than 3/4 of the referred patients but was not helpful when there was a severe stenoisis and/or the diseases segment could not be reached for biopsy. The incidence diminished when a small calibre fiberendoscope was used, practically always allowing to reach or to pass the stenotic segment. There were no false positive nor false negative endoscopical results in our study. In a substantial number of patients major surgical exploration could be prevented. We consider colonoscopy therefore a valuable adjunct in detecting or eliminating cancer in colonic diverticular disease. The availability of various fiberendoscopic instruments is a prerequisite for reaching an acceptable success rate and diagnostic accuracy.

Colon↗
PubMedDate not supplied

Diverticular disease of the colon.

Diverticular disease is basically a disorder of muscle function, particularly of the sigmoid colon. Increase in tone of the muscle layers of the bowel with consequent muscular thickening of a characteristic pattern. The thickening is not a true cellular hypertrophy and there is no evidence of muscle cell hyperplasia. The formation of diverticula are distributed along the points of greatest weakness in the bowel wall, namely where the blood supply penetrates, suggests that pulsion plays a major role in their development. The inflammation in diverticular disease is purely a complication of the diverticulosis.

Adult↗