ABSTRACT
Diverticular disease is a common condition responsible for significant costs to the healthcare system in the Western world. It ranges from asymptomatic diverticulosis to complicated diverticulitis. Here, we present a unique case of recurrent, complicated diverticulitis in a 62-year-old Caucasian male. Within a span of one year, he was hospitalized six times with diverticulitis before undergoing elective sigmoid colon resection. Imaging showed diverticulitis of distal descending and proximal sigmoid colon with sealed perforation, recurrent abscesses, and formation of colocutaneous fistulas. During each hospitalization, the patient was advised to follow up with general surgery and/or outpatient gastroenterology but chose not to do so. Eventually, he required an elective sigmoid colectomy with a takedown of the colocutaneous fistulas. In this case report, we discuss the atypical features and criteria for prophylactic colon resection in diverticulitis to highlight the importance of outpatient follow-up with general surgery and gastroenterology.
ABSTRACT
Bivalves are one of the most representative groups in the Phylum Mollusca, with over 1,100 freshwater species around the world except Antarctica. About 900 of these species belong to the Order Unionida Gray, 1854. In South America, the distributional range of the Unionida includes all countries in the region and extends as far south as the lakes and rivers of Argentinean-Chilean Patagonia. With the aim of generating distribution maps for the different genera of Unionida in Argentina, we consulted the databases of the nation's main official malacological collections. The data were analyzed and georeferenced using the point-radius method. Spatial analyses were performed with the software Q-GIS 2.16.3 Nødebo using vector layers under the 2007 Argentinean Geodesic Positions reference system. A total 1,833 lots were analyzed, of which it was possible to georeference 1,503. The distribution of Unionida in Argentinean territory was analyzed according to political provinces, Surface Drainage Basins and the Argentinean Protected Areas. Species richness was analyzed using the surface drainage basins of Argentina. We generate distribution maps for each genus and discuss the species threat status and conservation degree in the region. Only six (18%) of the Unionida present in Argentina have been classified by the IUCN, four are Least Concern and two are Data Deficient. This pattern is also valid for all of South America. More than 95% of the distributional range of the Unionida has no protected area. Conservation management is necessary for the preservation of Unionida diversity in southern South America.
