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2.
ABCD arq. bras. cir. dig ; 33(3): e1546, 2020. tab, graf
Article in English | LILACS | ID: biblio-1152618

ABSTRACT

ABSTRACT Background: The Hartmann procedure remains the treatment of choice for most surgeons for the urgent surgical treatment of perforated diverticulitis; however, it is associated with high rates of ostomy non-reversion and postoperative morbidity. Aim: To study the results after the Hartmann vs. resection with primary anastomosis, with or without ileostomy, for the treatment of perforated diverticulitis with purulent or fecal peritonitis (Hinchey grade III or IV), and to compare the advantages between the two forms of treatment. Method: Systematic search in the literature of observational and randomized articles comparing resection with primary anastomosis vs. Hartmann's procedure in the emergency treatment of perforated diverticulitis. Analyze as primary outcomes the mortality after the emergency operation and the general morbidity after it. As secondary outcomes, severe morbidity after emergency surgery, rates of non-reversion of the ostomy, general and severe morbidity after reversion. Results: There were no significant differences between surgical procedures for mortality, general morbidity and severe morbidity. However, the differences were statistically significant, favoring primary anastomosis in comparison with the Hartmann procedure in the outcome rates of stoma non-reversion, general morbidity and severe morbidity after reversion. Conclusion: Primary anastomosis is a good alternative to the Hartmann procedure, with no increase in mortality and morbidity, and with better results in the operation for intestinal transit reconstruction.


RESUMO Racional: O procedimento a Hartmann permanece sendo o tratamento de escolha da maioria dos cirurgiões para o tratamento cirúrgico de urgência da diverticulite perfurada, entretanto está associado com altas taxas de não reversão da ostomia e de morbidade pós-operatória. Objetivo: Estudar os resultados após o procedimento de Hartmann vs. ressecção com anastomose primária, com ou sem ileostomia, para o tratamento da diverticulite perfurada com peritonite purulenta ou fecal (grau de Hinchey III ou IV), e comparar as vantagens entre as duas formas de tratamento. Método: Busca sistemática na literatura de artigos observacionais e randomizados comparando ressecção com anastomose primária vs. procedimento de Hartmann no tratamento de urgência da diverticulite perfurada. Analisar como desfechos primários a mortalidade após a operação de urgência e a morbidade geral após ela; como desfechos secundários, a morbidade severa após a operação de urgência, as taxas de não reversão da ostomia, a morbidade geral e severa após a reversão. Resultados: Não houve diferenças significativas entre os procedimentos cirúrgicos para mortalidade, morbidade geral e morbidade severa. Contudo, as diferenças foram significativas estatisticamente favorecendo anastomose primária na comparação com procedimento de Hartmann nos desfechos taxas de não reversão do estoma, morbidade geral e morbidade severa após reversão. Conclusão: A anastomose primária apresenta-se como boa alternativa ao procedimento de Hartmann, sem aumento de mortalidade e morbidade, e com melhores resultados na operação de reconstrução do trânsito intestinal.


Subject(s)
Humans , Peritonitis/etiology , Colon, Sigmoid/surgery , Digestive System Surgical Procedures/adverse effects , Diverticulitis/surgery , Diverticulitis/complications , Intestinal Perforation/surgery , Peritonitis/surgery , Postoperative Complications , Digestive System Surgical Procedures/methods , Anastomosis, Surgical/methods , Colostomy/adverse effects , Ileostomy/adverse effects , Treatment Outcome , Diverticulitis/pathology , Intestinal Perforation/pathology
3.
Rev. gastroenterol. Méx ; 84(2): 220-240, April-June 2019.
Article in Spanish | LILACS, BIGG | ID: biblio-1026189

ABSTRACT

Desde la publicación en 2008 de las guías de diagnóstico y tratamiento de la enfermedad diverticular del colon de la Asociación Mexicana de Gastroenterología ha habido avances significativos en el conocimiento de esta enfermedad. Se realizó una revisión sistemática de la literatura en PubMed de enero de 2008 a julio de 2018 con el fin de revisar y actualizar las guías 2008 y proporcionar nuevas recomendaciones basadas en la evidencia. Se incluyeron todas las publicaciones en español e inglés, de alta calidad. Se redactaron los enunciados, que fueron votados utilizando el método Delphi. Se estableció la calidad de la evidencia y la fuerza de las recomendaciones según el sistema GRADE para cada enunciado. Cuarenta y tres enunciados fueron finalmente votados y calificados. Se informan nuevos datos sobre definición, clasificación, epidemiología, fisiopatología y factores de riesgo. Se revisó con especial énfasis la utilidad de la tomografía computarizada y de la colonoscopia, así como los métodos endoscópicos para el control de la hemorragia. Se discutió sobre el tratamiento ambulatorio de la diverticulitis no complicada, el papel de la rifaximina y la mesalazina, en el manejo de la diverticulitis aguda complicada tanto en sus alternativas mínimamente invasivas hasta las opciones quirúrgicas con énfasis en sus indicaciones, limitaciones y contraindicaciones. Los nuevos enunciados proporcionan directrices basadas en la evidencia actualizada. Se presentan la discusión, el grado y la fuerza de la recomendación de cada uno de ellos.


Subject(s)
Humans , Colonic Diseases/diagnosis , Colonic Diseases/prevention & control , Diverticulitis/complications , Diverticulitis, Colonic/diagnosis , Diverticulum, Colon/therapy , Mexico
4.
J. coloproctol. (Rio J., Impr.) ; 36(1): 50-52, Jan.-Mar. 2016. ilus
Article in English | LILACS | ID: lil-780056

ABSTRACT

Jejunoileal diverticulosis is an uncommon and underdiagnosed condition. Most patients are asymptomatic and require no specific treatment. A few patients, however, present life-threatening complications that may require surgical intervention. The purpose of this report is to illustrate a case of jejunoileal diverticulosis manifested as an acute abdomen.


A doença diverticular do intestino delgado é uma entidade incomum e pouco diagnosticada. A maioria dos casos não apresenta sintomas e não necessita de tratamento específico. Alguns pacientes, no entanto, podem evoluir com complicações da doença e necessitar de tratamento cirúrgico. O objetivo deste relato é ilustrar um caso de diverticulose jejunal que evoluiu para um quadro de abdome agudo.


Subject(s)
Humans , Male , Aged , Diverticulum/surgery , Diverticulitis/diagnosis , Diverticulitis/complications , Asymptomatic Diseases , Jejunal Diseases
5.
Hosp. Aeronáut. Cent ; 11(2): 115-9, 2016. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-910691

ABSTRACT

Introducción: La hemorragia digestiva baja (HDB) es aquella que tiene su origen en el tubo digestivo distal al ángulo de Treitz, representa aproximadamente el 20% de todos los casos de hemorragia digestiva. Los divertículos yeyunales e ileales son poco frecuente y una causa aún menos frecuente de HDB. Caso clínico: Se presenta una mujer de 68 años, que consulta por HDB con descompensación hemodinámica que requirió transfusiones de glóbulos rojos, y luego de múltiples estudios se hizo al diagnóstico con la parotomía exploradora y enteroscopía intraoperatoria. Evoluciona satisfactoriamente. Se realiza breve actualización de metodología diagnóstica y tratamiento de los divertículos yeyunales sangrantes


Introduction: Lower gastrointestinal bleeding (LGB) originates in the distal gut to Treitz, represents approximately 20% of all cases of gastrointestinal bleeding. The jejunal and ileal diverticula are rare causes of LGB. Clinical case: A woman aged 68, who consultes for LGB with hemodynamic decompensating requiring RBC transfusions, and after multiple studies was diagnosed with laparotomy exploratory and intraoperative enteroscopy. Evolves successfully. Brief update of diagnostic procedures and treatment of bleeding jejunal diverticula is performed


Subject(s)
Female , Diverticulitis/complications , Gastrointestinal Hemorrhage/etiology , Humans , Adult
7.
Rev. chil. urol ; 79(1): 54-56, 2014. ilus
Article in Spanish | LILACS | ID: lil-783420

ABSTRACT

Se presenta un caso de diverticulitis vesical en un paciente de 60 años con antecedente de obstrucción crónica al tracto de salida vesical (estenosis uretral), quien consulta por dolor pelviano inespecífico. Por lo anterior se realiza Resonancia Magnética (RM) de pelvis, que demuestra la presencia de un divertículo vesical de pared engrosada con cambios inflamatorios, los que comprometen además, la grasa peri-vesical. Este divertículo había sido detectado en RM pelviana un año antes. Se comenta el caso clínico, sus hallazgos a la RM y revisión de la literatura...


We report a case of bladder diverticulitis in a 60 years old patient with a history of chronic lower urinary tract obstruction (urethral stricture), who consulted for nonspecific pelvic pain. Pelvic magnetic resonance imaging (MRI) was obtained, demonstrating the presence of a bladder diverticulum with a thick wall and inflammatory changes involving the perivesical fat. The diverticulum had been detected on pelvic MRI a year earlier. We discuss the clinical case, the MRI findings and a review of the literature....


Subject(s)
Humans , Male , Middle Aged , Diverticulitis/complications , Diverticulitis/diagnosis , Urinary Bladder Diseases/complications , Urinary Bladder Diseases/diagnosis , Urethral Obstruction/etiology , Cystitis/etiology , Magnetic Resonance Imaging
9.
Rev. chil. cir ; 64(4): 368-372, ago. 2012. ilus, tab
Article in Spanish | LILACS | ID: lil-646966

ABSTRACT

Background: The usual surgical management of acute diverticulitis is Hartmann operation that is associated with high rates of complications and mortality. Recently, less invasive procedures, that avoid ostomies have been proposed as treatment, Alm: To analyze the results of laparoscopic peritoneal lavage in patients with acute diverticulitis. Material and Methods: Prospective analysis of seven patients age 25 to 61 years (four males) admitted for a first episode of acute diverticulitis classified as Hinchey II or III, in whom a percutaneous drainage of collections was not possible. All were subjected to a laparoscopic peritoneal lavage and debridement. Results: The mean body mass index of patients was 30.3 kg/m². Operative time was 55 +/- 28 min and there was no need for ostomies or conversion to open surgery. Two patients had complications. One required a percutaneous drainage of a collection and other required an open surgical procedure for peritoneal lavage. Patients stayed with nil per os for 2 +/- 1 days, required antimicrobials for 14 +/- 4 days and stayed in the hospital for 8 +/- 4 days. Conclusions: Laparoscopic peritoneal lavage is a good alternative surgical procedure for the treatment of acute diverticulitis.


Introducción: Tradicionalmente, el manejo quirúrgico de la diverticulitis aguda complicada (DAC) ha sido la operación de Hartmann. Sin embargo, ésta presenta tasas de morbilidad de 59 por ciento y mortalidad hasta de 12 por ciento. Han aparecido algunos procedimientos no resectivos con algunas ventajas operatorias y que evitarían la confección de una ostomía. Objetivo: Analizar resultados quirúrgicos de una serie de pacientes con DAC sometidos a lavado peritoneal sin resección por vía laparoscópica (LPL). Pacientes y Métodos: Serie de registro prospectiva de siete pacientes, que ingresaron con diagnóstico de DAC Hinchey II en que no fue posible el drenaje percutáneo de las colecciones y pacientes categorizados como Hinchey III, operados entre octubre de 2008 y noviembre de 2010. Resultados: Cuatro pacientes eran de sexo masculino. La edad media fue de 49 años, con un IMC de 30,3 kg/m². Todos los pacientes ingresaron con su primer episodio de DA. El tiempo operatorio fue de 55 +/- 28 minutos. No hubo necesidad de ostomía ni conversión. Dos pacientes presentaron complicaciones que requirieron de nuevos procedimientos durante su estadía. El tiempo de reposo digestivo fue de 2 +/- 1 días y la duración del esquema antibiótico fue de 14 +/- 4 días. La estadía hospitalaria fue de 8 +/- 4 días. Conclusiones: El LPL representa una alternativa al manejo quirúrgico tradicional. Las ventajas teóricas son bajas tasas de morbimortalidad, estadía hospitalaria más corta y sin la eventual necesidad teórica de una ostomía. Esta técnica requiere ser validada en el contexto de un estudio aleatorizado con claridad en criterios de inclusión y exclusión.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Diverticulitis/surgery , Drainage/methods , Laparoscopy/methods , Peritoneal Lavage/methods , Acute Disease , Diverticulitis/complications , Length of Stay , Postoperative Complications , Prospective Studies
10.
Article in Korean | WPRIM | ID: wpr-212475

ABSTRACT

Enterovesical fistular is an abnormal communication between the intestine and the bladder. It represents a rare complication of intestinal diverticulitis, colorectal malignancy, bladder cancer, inflammatory bowel disease, radiotherapy, and trauma. The most common etiology is diverticular disease. A 70-year-old man came to our hospital due to frequent urinary tract infection, dysuria, pneumaturia and fecaluria. Sigmoidoscopy revealed a large diverticulum with impacted stool at the sigmoid colon. When the scope was inserted into the site, the patient complained of severe urgency and pneumaturia. CT scan was performed. 1.5 cm sized fistular tract between the sigmoid colon and bladder was noted. According to the endoscopy and CT finding, the diagnosis of colovesical fistula was made. The patient underwent surgical intervention. At laparotomy, there were multiple diverticula and fistular tract was noted.


Subject(s)
Aged , Colon, Sigmoid/pathology , Diverticulitis/complications , Humans , Intestinal Fistula/diagnosis , Male , Sigmoidoscopy , Tomography, X-Ray Computed
11.
Article in English | WPRIM | ID: wpr-127690

ABSTRACT

The aim of this study was to examine the relationship of complications related to diverticulitis and visceral obesity. The study was based on a retrospective case note review conducted at the Hanyang University Hospital. Patients were diagnosed with diverticulitis based on clinical symptoms and abdominal computed tomography (CT) findings and divided into two groups: those admitted with complicated diverticulitis and those with a simple diverticulitis episode. We compared the body mass index (BMI) and degree of visceral obesity, measured by abdominal CT. The study included 140 patients, 87 (62.1%) were simple diverticulitis and 53 (37.9%) were complicated diverticulitis. In the complicated diverticulitis group, 9 (6.4%) cases were recurrent, 29 (20.7%) were perforation or abscess patients, and 28 (20%) were patients with systemic inflammatory response syndrome (SIRS). Of the SIRS patients, 13 were involved in other complication groups. When comparing in the two groups, the complicated diverticulitis group had a significantly higher visceral fat area (128.57 cm2 vs 102.80 cm2, P = 0.032) and a higher ratio of visceral fat area/subcutaneous fat area (0.997 vs 0.799, P = 0.014). Visceral obesity is significantly associated with complications of diverticulitis.


Subject(s)
Adipose Tissue , Adult , Aged , Body Composition , Body Mass Index , Diverticulitis/complications , Female , Humans , Intra-Abdominal Fat , Lipids/blood , Male , Middle Aged , Obesity, Abdominal/complications , Systemic Inflammatory Response Syndrome
12.
Rev. venez. cir ; 63(3): 144-147, sept. 2010. tab
Article in Spanish | LILACS | ID: lil-618772

ABSTRACT

Describir la utilidad y demostrar la seguridad del Robot Da Vinci®, en la cirugía general abdominal. Estudio realizado en el Hospital de Clínicas Caracas, Caracas-Venezuela. Estudio descriptivo, retrospectivo realizado entre junio 2006 y julio 2010, en pacientes que ameritaron cirugía abdominal y que fueron operados con el robot Da Vinci® (Intuitive Surgical, Sunnyvale, CA). Se incluyeron 61 pacientes, predominando el género femenino (82%), en edades comprendidas entre 21-80 años, que acudieron a la consulta y/o emergencia y que, accedieron a realizarse el abordaje laparoscópico asistido por el robot Da Vinci®. Entre las patologías mayormente operadas se encuentran: litiasis vesicular o colecistitis aguda y la hernia hiatal con reflujo gastroesofágico. Tuvimos 8% de complicaciones (entre mayores y menores). La cirugía abdominal laparoscópica asistida por robot, recupera la visión y la habilidad perdida con la cirugía laparoscópica convencional. En nuestra serie observamos no sólo los beneficios que el robot le brinda al cirujano, sino los que esta técnica le ofrece al paciente. La cirugía robótica ha probado ser de gran utilidad y segura.


To demostrate the safety and describe the benefits in abdominal general surgery. Study performed at the Hospital de Clínicas Caracas, Caracas-Venezuela. Retrospective study performed between 2006-2010 in patients who underwent abdominal surgery with the Da Vinci® robot (Intuitive Surgical, Sunnyvale, CA). Sixty one patients were included, 82% females, between 21-80 years. Elective and/or emergency abdominal surgery was performed after they agree to have the laparoscopic approach assited by the Da Vinci® robot. Gastroesophageal reflux disease with or withouth hiatal hernia, cholecistectomy were the frecuent pathologies. Minor and/or major complications where 8%. Laparoscopic approach with the Da Vinci® System, regains the tridimentional visión and the intuitive hand movements lost with the conventional laparoscopic approach. In our series robotic surgery is safe and brings benefits to the surgeon and the patients.


Subject(s)
Humans , Male , Adult , Female , Middle Aged , Aged, 80 and over , Cost-Benefit Analysis/methods , Laparoscopy/methods , Robotics/methods , Abdominal Injuries/surgery , Abdominal Injuries/pathology , Esophageal Achalasia/complications , Diverticulitis/complications
13.
Rev. Col. Bras. Cir ; 37(1): 081-082, ene.-feb. 2010. ilus
Article in Portuguese | LILACS | ID: lil-554498

ABSTRACT

Small Intestine's diverticulosis is an uncommon pathology of intestine. It's more evident at jejune and can be complicated by intestinal perforation, obstruction or diverticulitis, increasing the mortality. We describe a forty years old female patient that arrived at emergency service complained of diffuse abdominal pain. There aren't signals of peritonitis and the radiological evaluation showed small intestine's distension. Surgical intervention was performed revealing multiples diverticulums at jejune and intestinal perforation. The aim of this article is present a case of Small Intestine's diverticulosis and its complications that had precise intervention resulting in a favorable resolution.


Subject(s)
Adult , Female , Humans , Diverticulitis/complications , Intestinal Perforation/etiology , Jejunal Diseases/complications , Jejunal Diseases/etiology
14.
Rev. chil. cir ; 61(6): 544-546, dic. 2009. ilus
Article in Spanish | LILACS | ID: lil-556688

ABSTRACT

We present an unfrequent case of acute diverticulitis mimmicking acute prostatitis. Case report: A 72-year-old man suffering from hypogastric and genital pain, fever and dysuria, with an edematous and tender prostate at physical examination, was initially diagnosed of acute prostatitis. 24 hours later the patient developed left lower quadrant pain and abdominal distension. A CT scan was performed, showing pneumoperitoneum and acute sigmoid diverticulitis signs. The patient underwent a Hartmann's procedure.


Presentamos un caso infrecuente de diverticulitis aguda con manifestaciones clínicas sugerentes de prostatitis aguda. Caso clínico: Varón de 72 años, presenta dolor hipogástrico y en región genital, fiebre y disuria, palpándose una próstata edematosa y dolorosa al tacto rectal, por lo que es inicialmente diagnosticado de prostatitis aguda. A las 24 horas el paciente desarrolla un cuadro de distensión abdominal y dolor en fosa ilíaca izquierda. Una TC abdominal mostró neumoperitoneo y signos de diverticulitis aguda. Se intervino al paciente realizando una intervención de Hartmann.


Subject(s)
Humans , Male , Aged , Diverticulitis/surgery , Diverticulitis/complications , Diverticulitis/diagnosis , Prostatitis/etiology , Acute Disease , Urologic Diseases/etiology , Intestinal Perforation
15.
J. bras. med ; 97(2): 38-47, set.-out. 2009. ilus, tab
Article in Portuguese | LILACS | ID: lil-541127

ABSTRACT

Diverticulite é uma complicação inflamatória aguda dos tecidos peridiverticulares em consequência à perfuração de pseudodivertículos colônicos. A doença diverticulite é a doença colônica mais comum no mundo ocidental. Dois principais fatores estão envolvidos na formação dos divertículos colônicos: uma dieta pobre em fibras e a fragilidade relativa nas áreas de penetração das artérias nutrientes na parede do cólon. Na sua forma complicada - diverticulite - a apresentação mais típica é a dor no quadrante inferior esquerdo (OIE), febre, calafrios e taquicardia. Os autores relata a fisiopatologia, o diagnóstico clínico e o diagnóstico diferencial. Analisam também os exames de imagem utilizados e suas principais indicações, além das complicações e terapêuticas.


Subject(s)
Male , Female , Diverticulitis/complications , Diverticulitis/diagnosis , Diverticulitis/physiopathology , Diverticulitis/therapy , Diagnosis, Differential , Mesalamine/therapeutic use , Rifamycins/therapeutic use , Tomography , Ultrasonography
17.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2009; 19 (2): 120-122
in English | IMEMR | ID: emr-91610

ABSTRACT

Although uncommon, jejunoileal diverticula are associated with significant morbidity and mortality. Both acute and chronic symptoms can be varied and non-specific, making jejunoileal diverticular disease a diagnostic and therapeutic challenge. We report a case of jejunal diverticular disease, complicated by acute diverticulitis, in a 75-year-old male who was successfully treated with conservative approach. The non-surgical approach was enabled by early assessment with multislice CT and active close observation


Subject(s)
Humans , Male , Ileum/abnormalities , Diverticulum/complications , Diverticulum/mortality , Diverticulum/pathology , Diverticulitis/complications , Diverticulitis/mortality , Diverticulitis/therapy , Intestine, Small/abnormalities , Abdomen, Acute/etiology , Tomography, Spiral Computed
18.
Article in English | IMSEAR | ID: sea-92762

ABSTRACT

We report a 59 years male who presented with urinary tract infection due to a colovesical fistula secondary to colonic diverticuli.


Subject(s)
Colonography, Computed Tomographic , Diagnosis, Differential , Diverticulitis/complications , Humans , Intestinal Fistula/diagnosis , Male , Middle Aged , Urinary Tract Infections/diagnosis
19.
Article in English | WPRIM | ID: wpr-54093

ABSTRACT

Enterovesical fistula is a relatively uncommon complication of colorectal and pelvic malignancies, diverticulitis, inflammatory bowel disease, radiotherapy, and trauma in Asian countries. A case of vesico-ileosigmoidal fistula and a literature review of this disease in Japan are presented. A 70-yr-old male was referred with complaints of urinary pain and pneumaturia. On admission, urinary tract infection and pneumaturia were presented. A barium enema demonstrated multiple diverticulum in his sigmoid colon and the passage of contrast medium into the bladder and ileum. Under the diagnosis of vesico-ileosigmoidal fistula due to suspected diverticulitis of the sigmoid colon, sigmoidectomy and partial resection of the ileum with partial cystectomy were performed. The histopathology revealed diverticulosis of the sigmoid colon with diverticulitis and development of a vesico-ileosigmoidal fistula. No malignant findings were observed. Until the year 2000, a total of 173 cases of vesico-sigmoidal fistula caused by diverticulitis had been reported in Japan. Pneumaturia and fecaluria are the most common types, presenting symptoms in 63% of the cases. Computed tomography, with a sensitivity of 40% to 100%, is the most commonly used diagnostic study. For patients with vesico-sigmoidal fistula, resection of the diseased sigmoid colon and partial cystectomy with primary anastomosis are the safest and most acceptable procedures, leading to the best results.


Subject(s)
Aged , Anastomosis, Surgical , Urinary Bladder Fistula/etiology , Colon, Sigmoid/pathology , Cystectomy , Diverticulitis/complications , Humans , Ileum/pathology , Male
20.
Rev. méd. Chile ; 130(8): 869-878, ago. 2002.
Article in Spanish | LILACS | ID: lil-356155

ABSTRACT

BACKGROUND: Ten to 22 per cent of lower gastrointestinal bleedings require emergency surgery. The overall mortality of the procedure is 22 per cent. AIM: To report our experience in the management of patients with massive lower gastrointestinal bleeding. PATIENTS AND METHODS: Retrospective analysis of 20 patients (10 male) aged 19 to 79 years old, with lower gastrointestinal bleeding. RESULTS: Nine patients were operated on after the bleeding stopped and 11 were operated while still bleeding. In ten, the cause of bleeding was diverticular disease or angiodysplasia. In four, the bleeding originated in the small bowel and in 7 it was of vascular origin. Two patients with a torrential bleeding, were operated on without prior study. Colonoscopy, done in 18 patients, identified the bleeding site in 66 per cent of cases. Scintigraphy was performed in 7 patients and it was positive in five without operative mortality. Selective angiography was done in four patients and was positive in three. A partial intestinal resection was performed in 15 patients and a total colectomy in five without operative mortality. Six patients had major postoperative complications and mean hospital stay was 18 days. Patients have been followed for 9 to 144 months and six have died. Eleven patients were reassessed and all have complete fecal continence. CONCLUSIONS: In this series, the main causes of massive lower gastrointestinal bleeding were diverticulosis and angiodysplasia. In a high percentage of patients, the bleeding originated in the small bowel.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Gastrointestinal Hemorrhage/etiology , Angiodysplasia/complications , Colonoscopy , Diverticulitis/complications , Diverticulum, Colon/complications , Follow-Up Studies , Gastrointestinal Hemorrhage/surgery , Intestine, Small/surgery , Retrospective Studies , Treatment Outcome
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