Summary
Background
Right-sided colonic diverticulitis (RD) is much rarer than left-sided (LD) and controversies concerning the most appropriate treatment remain unsolved. Most Western centers treat ...RD with inpatient management independently of the severity of the disease. The aim of this study is to compare RD and LD patients who were treated as inpatients in order to define the RD patients who could benefit from outpatient management.
Methods
We performed a retrospective comparative study in which all acute diverticulitis patients admitted to our hospital from June 2015 to December 2019 were included. Clinical features, radiological findings, type of treatment, complications rate, and relapse time were analyzed in both groups.
Results
From a total of 239 patients, 24 patients with RD and 94 patients with LD were included. American Society of Anesthesiologists (ASA) classification was significantly lower in RD (
p
= 0.005). The presence of pneumoperitoneum in CT scan was significantly higher in LD (
p
= 0.001) and no RD patient required any kind of surgical intervention including percutaneous drainage. In contrast, 23.4% of LD patients needed a surgical procedure (
p
= 0.001). Third-line antibiotics of were only prescribed in left diverticulitis (
p
= 0.003). Length of hospital stay was significantly shorter in RD patients (
p
= 0.001).
Conclusion
Patients with right diverticulitis had fewer perforations, required lower-spectrum antibiotics, and did not require any surgical treatment, with a shorter length of hospital stay. Given these results, we consider that mild right diverticulitis could benefit from an outpatient treatment following similar recommendations to those followed for mild LD patients. This is one of the largest series in Western literature and the only one that compares clinical features, complication rates, and type of treatment between right and left diverticulitis. Outpatient management in RD is a feasible option which is not only safe but can also reduce costs.
Pelvic actinomycosis secondary to intrauterine device Hernández-Alonso, Ricardo; Ferrer Vilela, Irene; Fernández del Castillo Ascanio, Mónica ...
Revista española de enfermedades digestivas,
11/2023
Journal Article
Recenzirano
Odprti dostop
Actinomycosis is a rare bacterial infection causing lesions and abscesses, often mimicking tumors. It commonly affects the cervicofacial, abdominal, and thoracic regions. We present a case of a woman ...with an intrauterine device (IUD) who developed an abscess and abdominal symptoms. Initial studies suggested a tumor, but biopsy revealed inflammation. Subsequently, she was diagnosed with Actinomyces Israelii infection, her IUDwas removed, and she was treated with penicillin, resulting in improvement. Pelvic actinomycosis is uncommon and often diagnosed late, often post-surgery, requiring combined surgical and medical treatment.
Bowel obstruction is an uncommon clinical presentation in Burkitt´s lymphoma, specially in adults. This type of lymphoma is classified within B-cell non-Hodgkin´s lymphomas, which is characterized by ...its aggressiveness and quickly tumoral growth. The clinical presentation related to the gastrointestinal tract is unusual, but it can be presented as intussusception, obstruction or ischemic perforation. Here we describe a case of Burkitt´s lymphoma with bowel obstruction as a clinical debut.
Crossed renal ectopia is a rare pathology that is often asymptomatic. Intraoperative detection with a sigma complicated neoplasia is more infrequent and requires correct management to avoid a renal ...ureteral injury.
To present a case report of a patient with a sigma complicated neoplasia and a crossed renal ectopia detected incidentally.
We present the case of a 62-year-old man that was submitted for emergency surgery for a sigma perforated neoplasm, and who presented with a previously undiagnosed left-side CRE. During surgery there was a need to insert 2-double-J stents as a guide to both ureters and to avoid any injury to them.
Crossed renal ectopia is a rare, often asymptomatic entity, the diagnosis of which is usually incidental. In our case, the detection of a concomitant complicated neoplasm, required identification of both ureters due the anatomic doubt of its localization and to avoid them being injured. In conclusion, upon finding a casual crossed renal ectopia during an emergency surgery of sigma, we recommend the identification of the ureters to facilitate its location and to avoid any injury to the ureters.
La ectopia renal cruzada es una enfermedad rara, que habitualmente cursa de forma asintomática. El hallazgo intraoperatorio de la misma ante una neoplasia de sigma complicada es aún más infrecuente, ...y requiere de un manejo adecuado para evitar la lesión reno-ureteral.
Presentar un caso clínico de un paciente con neoplasia de sigma complicada y ectopia renal cruzada, hallada de forma incidental.
Presentamos el caso clínico de un paciente de 62 años que es intervenido de forma urgente por una neoplasia de sigma perforada, el cual presenta una ectopia renal cruzada hacia el lado izquierdo, desconocida previamente. Durante la intervención requiere la colocación de 2 drenajes ureterales para tutorizar ambos uréteres y evitar la lesión de los mismos.
La ectopia renal cruzada es una rara entidad, que a menudo suele ser asintomática, y cuyo diagnóstico suele ser incidental. En nuestro caso, la presencia de la neoplasia complicada requiere la tutorización de ambos uréteres ante la duda anatómica de su localización, y para evitar la lesión del mismo. En conclusión, ante el hallazgo casual de una ectopia renal cruzada, durante la cirugía de urgencia del sigma, es recomendable la identificación de los uréteres para facilitar su localización y evitar la lesión de los mismos.
Crossed renal ectopia is a rare pathology that is often asymptomatic. Intraoperative detection with a sigma complicated neoplasia is more infrequent and requires correct management to avoid a renal ureteral injury.
To present a case report of a patient with a sigma complicated neoplasia and a crossed renal ectopia detected incidentally.
We present the case of a 62-year-old man that was submitted for emergency surgery for a sigma perforated neoplasm, and who presented with a previously undiagnosed left-side CRE. During surgery there was a need to insert 2-double-J stents as a guide to both ureters and to avoid any injury to them.
Crossed renal ectopia is a rare, often asymptomatic entity, the diagnosis of which is usually incidental. In our case, the detection of a concomitant complicated neoplasm, required identification of both ureters due the anatomic doubt of its localization and to avoid them being injured. In conclusion, upon finding a casual crossed renal ectopia during an emergency surgery of sigma, we recommend the identification of the ureters to facilitate its location and to avoid any injury to the ureters.
This work collects the presentations made at the III International Seminar Memory of Law and Legal Disciplines (XIX-XX centuries) held on May 25 and 26, 2022 at the Santa María de la Rábida Campus of ...the International University of Andalusia, in Palos de la Frontera, Huelva. The following pages discuss the lives of legal scholars as well as the emergence of legal disciplines and legal education in Spain in the period spanning from the Moyano Law of Public Instruction (1857) to the University Reform Law (1983).
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