Perforated Duodenal Diverticulum Treated Conservatively: Another Two Successful Cases.

Diverticula of the duodenum proceed those of the colon in respect to frequency of location. Incidence at times of autopsy ranges from 15 to 23%. Despite the fact that more than 90% of duodenal diverticulum cases are asymptomatic, complications if they do occur can be calamitous. Perforation is one of these rare complications. Surgical intervention has always been the mainstay for symptomatic/complicated duodenal diverticula, but with the advancement of imaging, medical treatment, and proper intensive observation, conservative treatment came forth. We hereby present two cases of duodenal diverticula, complicated by perforation and fistulization into the retroperitoneal cavity, both treated conservatively by Taylor's approach of upper gastrointestinal tract perforation. Review of other cases of duodenal diverticulum perforation has also been presented.

Copro-antigen versus classical microscopy as diagnostic tool for giardia lamblia infection in Egyptian patients

Background: Giardia lamblia, a flagellate protozoa, is a one of the most common causes of non-viral (parasitic) diarrheal illness in humans. Laboratory diagnosis mainly consists of direct microscopic examination of stool specimen for trophozoites and cysts. However, due to intermittent fecal excretion of the parasite, the patient may be misdiagnosed, continue excreting the parasite and infecting others. Therefore, other methods of diagnosis should be looked for, which overcome the drawbacks of microscopy when used alone for diagnosis. The present study aimed to evaluate the efficacy of coproantigen detection by ELISA test in comparison to direct microscopy in the diagnosis of G. lamblia in stool specimens from patients with diarrhea and other gastrointestinal symptoms. Patients and methods: stool samples were collected form 250 child included in the present study (150 symptomatic and 100 apparently healthy as a control group) aged between 1-10 years old, and subjected for direct microscopic examination and ELISA test for copro-antigen detection. Results: out of 250 stool samples, 53 specimens (21.2%) were positive for Giardia by direct microscopy, while 68 specimens (27.2%) were positive by ELISA test. Conclusion: ELISA test for copro-antigen detection in stool samples is a rapid and effective method with high sensitivity and specificity for diagnosis of giardiasis in stool specimens even when the parasitic count is low, thus reducing the chances of missing even in the asymptomatic cases