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Fulltext Perforated incisional littre’s hernia: a rare content of a common hernia

Kumarappan, A.l., Norly, S., Samuel Tay, Vicknesh, C.

International Medical Journal Malaysia, 2016;15(2):81-84.
MyJurnal

Anticipation of complications is of paramount importance for a surgeon. Incisional hernia is a well-known
complication for abdominal surgeries. Risk factors such as increasing age, obesity, male gender are well
known. Intestinal obstruction, strangulation and perforation are imminent complications of this type of
hernia if they become incarcerated. Common contents of a ventral incisional hernia are small bowel, large
bowel and omentum. Even though Meckel’s diverticulum is a common gastrointestinal anomaly, it is rarely
found to be the content of a hernial sac. A hernia sac containing Meckel’s diverticulum is also known as
Littre’s hernia. Only a few cases have been reported in the literature. Thus here we present a case of
perforated Meckel’s diverticulum that was entrapped in the ventral incisional hernia.

Matched MeSH terms: Meckel Diverticulum
Caustic strictures of the oesophagus

Skene-Smith H

Br J Radiol, 1975 Aug;48(572):646-8.
PMID: 810200

Twenty-two cases of corrosive oesophageal strictures were reviewed and divided into annular, short segment and long segment lesions. The lower third of the oeseophagus was involved in all the long segment strictures, but with sparing of the extreme distal portion in most. Irregularity of the stricture walls with an appearance similar to reported cases of intramural diverticulosis is a common finding but smooth strictures can also occur.

Matched MeSH terms: Diverticulum/radiography
Inflammatory diseases of the bowel: a Malaysian experience

Ti TK

Aust N Z J Surg, 1979 Aug;49(4):428-31.
PMID: 115452

A 10-year experience in the diagnosis and treatment of 92 patients with inflammatory bowel diseases in Kuala Lumpur is described. Tuberculosis (34 cases) was the most common inflammatory bowel disease of surgical importance. The clinical presentation of tuberculous enteritis and Crohn's disease is similar, though tuberculosis is strongly suggested by associated pulmonary disease and radiological evidence of caecal involvement. The finding of 10 cases each of Crohn's disease and ulcerative colitis is in keeping with an increased awareness of these conditions in a developing urban society where facilities exist for thorough investigation of diarrhoeal diseases. Amoebiasis sometimes causes a granulomatous lesion simulating carcinoma. Diverticular disease of the colon as known in the West is of very rare occurrence.

Matched MeSH terms: Diverticulum/surgery
Giant Intradiverticular Bladder Tumor

Md Noh MS, Abdul Aziz AF, Mohd Ghani KA, Lee Kheng Siang C, Yunus R, Mohd Yusof M

Am J Case Rep, 2017 Mar 01;18:212-216.
PMID: 28246375

BACKGROUND Intradiverticular bladder tumors are rare. This renders diagnosis of an intradiverticular bladder tumor difficult. Imaging plays a vital role in achieving the diagnosis, and subsequently staging of the disease. CASE REPORT A 74-year-old male presented to our center with a few months history of constitutional symptoms. Upon further history, he reported hematuria two months prior to presentation, which stopped temporarily, only to recur a few days prior to coming to the hospital. The patient admitted to having lower urinary tract symptoms. However, there was no dysuria, no sandy urine, and no fever. Palpation of his abdomen revealed a vague mass at the suprapubic region, which was non tender. In view of his history and the clinical examination findings, an ultrasound of the abdomen and computed tomography (CT) was arranged. These investigations revealed a giant tumor that seemed to be arising from a bladder diverticulum, with a mass effect and hydronephrosis. He later underwent operative intervention. CONCLUSIONS Intradiverticular bladder tumors may present a challenge to the treating physician in an atypical presentation; thus requiring a high index of suspicion and knowledge of tumor pathophysiology. As illustrated in our case, CT with its wide availability and multiplanar imaging capabilities offers a useful means for diagnosis, disease staging, operative planning, and follow-up.

Matched MeSH terms: Diverticulum*
Fulltext Intestinal knot in acute Meckel's diverticulitis

Ezrien DE, Hayati F, Nik Lah NAS, Zakaria AD

BMJ Case Rep, 2019 Nov 24;12(11).
PMID: 31767613 DOI: 10.1136/bcr-2019-232611
Matched MeSH terms: Meckel Diverticulum/complications*
Fulltext Factors associated with the recurrence of complicated diverticular disease

Azlanudin Azman, Ismail Sagap

Journal of Surgical Academia, 2011;1(1):6-14.
MyJurnal

Colonic diverticula is observed in over 60% of the western population aged over 80 where up to 30% will eventually be symptomatic and may develop complications. The natural history and etiology of colonic diverticula have been well described. However, predictive indicators of complicated diverticular disease are not known thus preventing the prophylactic treatment of this subset of patients,. The aim of this study was to observe patients with complicated diverticular disease in order to identify common factors associated with recurrent complications. All hospital admissions from January 2005 to December 2008 for complications of diverticular disease were recruited. Using logistic regression, demographic data and factors such as clinical presentation, nature of complication, lifestyle, concomitant medical illness and medications that may be associated with recurrent episodes of complications were analyzed. A total of 121 patients were diagnosed with complicated diverticular disease during the study period with 24 patients having recurrent complications. Logistic regression analysis performed after controlling for confounders found active smoking (p=0.006) and alcohol consumption (p=0.036) along with underlying diabetes (p=0.031) and dyslipidemia (p=0.039) significantly associated with an increased risk of recurrent complications. We therefore concluded that smoking, alcohol consumption, diabetes mellitus and dyslipidemia are associated with recurrent complicated colonic diverticular disease. As these are modifiable risk factors, they should be sought for during the presentation of the first attack. Aggressive control of these factors will help in reducing the risk of recurrent complications.

Matched MeSH terms: Diverticulum, Colon
Fulltext A complicated urethrovaginal fistula following an inappropriate urethral diverticulum management

Lo TS, Jaili SB, Ibrahim R

Taiwan J Obstet Gynecol, 2017 Aug;56(4):534-537.
PMID: 28805613 DOI: 10.1016/j.tjog.2016.10.004

OBJECTIVE: Urethral diverticulum is uncommon, therefore appropriate evaluation, preoperative planning and counseling must be done in order to make correct diagnosis and prevent complications.
MATERIALS AND METHODS: A case of anterior vaginal wall mass was treated elsewhere by a gynecologist as periurethral cyst abscess; incision and drainage were done but a symptom of pus discharge was observed after 2 weeks. Therefore, exploration, cyst wall excision and primary closure were done though histopathological examination surprisingly confirmed the presence of urethral tissue suggestive of diverticulum.
RESULTS: Subsequently, she developed persistent urinary leakage along with urethrovaginal fistula for which they again performed pervaginal multilayer closure. Patient was later referred to us with recurrent urethrovaginal fistula. We performed posterior urethral fistulectomy with anterior vaginal wall flap and multilayer closure. Three years follow up reveals complete recovery.
CONCLUSION: Even urethral diverticulum is a rare condition, should be kept in mind as early diagnosis and management.

Matched MeSH terms: Diverticulum/surgery*