The importance of endoscopy in the diagnosis of neoplasms associated with diverticular disease of the colon, and its effect on surgical treatment.

The results of fibercolonoscopy performed in 149 patients with clinical and or X-ray appearances of diverticular disease are reported. Examination could not be completed in 16 per cent of patients because of impassable strictures in the left colon. Concurrent lesions were diagnosed in 69 per cent, and carcinoma was found in 6 per cent. The respective role of endoscopy and radiology are compared in the diagnosis of polyps, strictures, and cancer, coexisting with diverticulosis. It is concluded that colonoscopy is always indicated in diverticulosis with symptoms because it often provides a precise differential diagnosis thus obviating useless operations. Surgery is essential when impassable strictures prevent colonoscopy because the underlying conditions always require surgical treatment.

Manometric study of the sphincter of Oddi in patients with and without common bile duct stones.

Motor activity of the sphincter of Oddi has been evaluated in 34 patients who underwent ERCP examination. Manometric recordings from the common bile duct and the sphincter of Oddi were performed with a polyethylene triple lumen catheter. At ERCP 16 patients had undamaged biliary ducts; six had undergone cholecystectomy and six had gall bladder stones; 18 patients had common bile duct stones; nine of whom had undergone cholecystectomy, and seven had gall bladder stones. Length and amplitude of the resting sphincter pressure as well as frequency, duration, amplitude, and propagating pattern of phasic contractions did not significantly differ in patients with and without common bile duct stones. Sphincter of Oddi motor activity did not appear to be influenced by the variation in the diameter of the common bile duct or by previous cholecystectomy.