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1.
ANZ J Surg ; 93(12): 2828-2832, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37743578

RESUMO

BACKGROUND: Gastric diverticula (GD) are the rarest form of gastrointestinal tract diverticulum, with an estimated incidence of 0.013-2.6%. GD are poorly understood and there are no established management guidelines. Only sparse updates have been published since the mid-20th century. This paper reviews the current literature and provides some suggested guidelines for the management of GD. METHODS: A search of Medline via OvidSP and Google Scholar for 'gastric diverticulum' and associated synonyms from the year 1950 onwards was performed. We included randomized controlled trials (RCTs), cohort and case-control studies, and case series. Full text, English language manuscripts on adult populations were included. RESULTS: A total of 103 manuscripts were included in the final selection - 77 individual case studies, 23 case series and three reviews. No RCTs, cohort or case-control studies were found. The case studies represent 305 patients, 50.8% female with average age 49.2 years (range 18-80). The most common symptom was abdominal pain (48.2%). The average maximum diameter was 3.97 cm (range 0.5-9). One hundred and four patients were managed operatively. Despite persistent recommendations in the literature that GD > 4 cm should be considered for resection, there are no data supporting this approach. CONCLUSION: The evidence pertaining to the management of GD is sparse. The decision for operative management should be individualized and based primarily on the presence of symptoms or complications which may be directly attributable to the GD. Where surgery is indicated, a laparoscopic approach, potentially with intra-operative gastroscopy, is appropriate.


Assuntos
Divertículo Gástrico , Adulto , Feminino , Humanos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Masculino , Divertículo Gástrico/diagnóstico , Divertículo Gástrico/epidemiologia , Divertículo Gástrico/cirurgia , Gastroscopia , Estômago , Dor Abdominal/complicações , Estudos de Casos e Controles
2.
S D Med ; 75(suppl 8): s21, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36745993

RESUMO

Gastric diverticula are quite rare and can be either acquired or congenital. Resection is recommended when the diverticula are large (>4 cm), PPI therapy does not relieve symptoms, and/or complications arise. We present a case of a patient with a long-standing history of symptoms related to a congenital gastric diverticulum that had been found incidentally on imaging during a workup for possible small bowel obstruction. The patient underwent a successful laparoscopic, robotic assisted surgical resection of the congenital gastric diverticulum with complete relief of his symptoms.


Assuntos
Divertículo Gástrico , Obstrução Intestinal , Laparoscopia , Humanos , Divertículo Gástrico/diagnóstico por imagem , Divertículo Gástrico/cirurgia , Divertículo Gástrico/complicações , Laparoscopia/métodos , Intestino Delgado
3.
Khirurgiia (Mosk) ; (4): 70-73, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32352672

RESUMO

Gastric diverticulum is a rather rare disease. This lesion is diagnosed in about 0.01% of cases during contrast-enhanced X-ray examination and in 0.04-0.11% of patients undergoing endoscopic examination. Symptomatic diverticulum is complicated by diverticulitis, bleeding, perforation and malignant transformation. Therefore, surgical resection is indicated. We report surgical treatment of a patient with diverticulum of the cardiac part of the stomach. Endoscopic and X-ray examination was valuable to establish the correct diagnosis. Laparoscopic approach minimized surgical trauma and reduced surgery time.


Assuntos
Divertículo Gástrico/diagnóstico , Divertículo Gástrico/cirurgia , Estômago/cirurgia , Divertículo Gástrico/complicações , Humanos , Laparoscopia
4.
Pan Afr Med J ; 32: 80, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223371

RESUMO

Gastric diverticula are the most uncommon form of gastrointestinal diverticula. They can either be of true or false type with different pathogenesis. They may be very challenging to diagnose as symptoms are nonspecific and imaging can simulate a malignant lesion. We report an unusual case of pre-pyloric diverticulum in a 69-year-old man, leading to severe gastric obstruction with a poor general condition. As subsequent endoscopy and imaging were alarming and couldn't exclude malignancy, the patient underwent an antrectomy. The final diagnosis was made on pathological examination. We discuss, through this case, the clinical and pathological features of gastric diverticula with an emphasis on the pathogenesis of this rare entity and the risk of a malignant transformation.


Assuntos
Divertículo Gástrico/diagnóstico , Gastrectomia/métodos , Neoplasias Gástricas/diagnóstico , Idoso , Divertículo Gástrico/patologia , Divertículo Gástrico/cirurgia , Humanos , Masculino
7.
JSLS ; 18(1): 120-4, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24680154

RESUMO

Gastric diverticula are rare and usually asymptomatic. This report, however, describes two examples of symptomatic gastric diverticula successfully treated by laparoscopic resection. Both patients were male and in their sixth decade of life. One patient was relatively healthy with no past medical history, whereas the other patient had chronic pain issues and at presentation was also undergoing evaluation for hyperaldosteronism. The patients presented with gastrointestinal symptoms, including nausea, emesis, abdominal pain, and change in bowel function. In both cases, a gastric diverticulum was identified by CT scan, and precise anatomic position was determined by upper endoscopy. After discussion with the treating teams, including a gastroenterologist and surgeon, surgical treatment and resection was elected. Successful laparoscopic removal was accomplished in both patients, and they were discharged home after tolerating liquid diets. Both patients reported resolution of their abdominal symptoms at follow-up.


Assuntos
Dor Abdominal/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Divertículo Gástrico/cirurgia , Laparoscopia/métodos , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Divertículo Gástrico/complicações , Divertículo Gástrico/diagnóstico , Endoscopia Gastrointestinal , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
8.
World J Gastroenterol ; 19(36): 6114-7, 2013 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-24106415

RESUMO

Gastric diverticula are rare and uncommon conditions. Most gastric diverticula are asymptomatic. When symptoms arise, they are most commonly upper abdominal pain, nausea and emesis, while dyspepsia and vomiting are less common. Occasionally, patients with gastric diverticula can have dramatic presentations related to massive bleeding or perforation. The diagnosis may be difficult, as symptoms can be caused by more common gastrointestinal pathologies and only aggravated by diverticula. The appropriate management of diverticula depends mainly on the symptom pattern and as well as diverticulum size. There is no specific therapeutic strategy for an asymptomatic diverticulum. Although some authors support conservative therapy with antacids, this provides only temporary symptom relief since it is not able to resolve the underlying pathology. Surgical resection is the mainstay of treatment when the diverticulum is large, symptomatic or complicated by bleeding, perforation or malignancy, with over two-thirds of patients remaining symptom-free after surgery, while laparoscopic resection, combined with intraoperative endoscopy, is a safe and feasible approach with excellent outcomes. Here, we present two cases of uncommon large symptomatic gastric diverticula with a discussion of the cornerstones in management and report a minimally invasive solution, with a brief review of the literature.


Assuntos
Divertículo Gástrico , Dor Abdominal/etiologia , Divertículo Gástrico/complicações , Divertículo Gástrico/diagnóstico , Divertículo Gástrico/cirurgia , Endoscopia Gastrointestinal , Feminino , Humanos , Laparoscopia , Pessoa de Meia-Idade , Grampeamento Cirúrgico , Resultado do Tratamento
12.
Rozhl Chir ; 91(9): 481-5, 2012 Sep.
Artigo em Eslovaco | MEDLINE | ID: mdl-23152991

RESUMO

Gastric diverticula represent a rare pathological condition. They are usually asymptomatic and are often found only by accident during radiologic or endoscopic examination, or during autopsy. Their incidence is low and evenly distributed between men and women. Gastric diverticula are most frequently located on the posterior wall of the cardia and on the lesser curvature of the stomach. The authors present a case study of a 58-year-old patient with severe sideropenic anaemia, a marked weight loss and non-specific dyspeptic symptoms. The suspicion of a diverticulum was raised by a gastroenterologist during gastrofibroscopy and confirmed by a radiologist following a dynamic CT examination of the stomach. The diverticulum had an atypical location beneath the cardia on the greater curvature. The patient was indicated for surgery. During conventional laparotomy, resection of the diverticulum was performed using a linear stapler. The postoperative course was uneventful. Histology confirmed a false diverticulum. The patient is doing well, is asymptomatic, has put on 7 kg since the operation and her blood count is normal.


Assuntos
Anemia Ferropriva/etiologia , Divertículo Gástrico/complicações , Divertículo Gástrico/diagnóstico , Divertículo Gástrico/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade
13.
JSLS ; 16(3): 473-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23318077

RESUMO

BACKGROUND: Gastric diverticulum (GD) is an extremely rare disorder that can easily be overlooked when investigating the cause of abdominal pain. Its diagnosis is founded on a history of gastrointestinal symptoms and a typically unrevealing physical examination, and diagnosis requires confirmation from UGI contrast studies, EGD, and CT scan. Symptomatic GD should be kept in consideration as a cause of abdominal issues, because not only is it treatable, but also complications of GD can be life threatening. The surgical treatment of GDs has evolved from thoraco-abdominal incisions in the early twentieth century to the laparoscopic approach used today. CASE REPORT: The patient is a 45-y-old male presenting with a 4-mo case of dysphagia, small amounts of regurgitation, and abdominal pain but no other symptoms. RESULTS: The patient was diagnosed with a gastric diverticulum, which was subsequently successfully treated with a laparoscopic gastric diverticulectomy. CONCLUSION: Laparoscopic gastric diverticulectomy is a safe procedure and should be considered as an option to treat symptomatic GD.


Assuntos
Transtornos de Deglutição/etiologia , Divertículo Gástrico/cirurgia , Laparoscopia/métodos , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/cirurgia , Diagnóstico Diferencial , Divertículo Gástrico/complicações , Divertículo Gástrico/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade
14.
Rev. cuba. cir ; 50(4)oct.-dic. 2011.
Artigo em Espanhol | CUMED | ID: cum-49553

RESUMO

La enfermedad diverticular duodenal es considerada en el ámbito de la cirugía de vías digestivas como inusual. Por su parte, la complicación menos frecuente referida en la literatura médica lo constituye la perforación aguda, y cuando esta ocurre siempre se practicará tratamiento quirúrgico de urgencia. Resulta polémico llegar a un consenso general que dirija la metodología diagnóstica, debido a su atípica forma de presentación. La tomografía abdominal ha resultado de gran utilidad en el diagnóstico de esta entidad. Se reportan tasas de mortalidad altas (25-30 por ciento) originadas, generalmente, por la dificultad diagnóstica frente a esta enfermedad. Se presenta un nuevo caso de divertículo duodenal perforado en una paciente, del sexo femenino, de 60 años de edad. La técnica quirúrgica empleada en esta oportunidad consistió en la exclusión duodenal y el drenaje del retroperitoneo(AU)


The duodenal diverticular disease is considered within surgery of digestive tracts as unusual. The less frequent complication referred in medical literature is the acute perforation and when it occurs always will be carried out the emergency surgical treatment. It is polemic to arrive to a general consensus directing the diagnostic methodology due to its atypical way of presentation. The abdominal tomography has been very useful in diagnosis of this entity. Authors report high mortality rates (25-30 percent) in general originated by the diagnostic difficulty in face of this disease. A new case of perforated duodenal diverticulum of a female sex patient aged 60. The surgical technique used in this opportunity was the duodenal exclusion and the retroperitoneal drainage(AU)


Assuntos
Humanos , Feminino , Idoso , Divertículo Gástrico , Abdome Agudo/etiologia , Divertículo Gástrico/cirurgia , Abdome Agudo/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos
15.
Rev. cuba. cir ; 50(4): 570-575, oct.-dic. 2011.
Artigo em Espanhol | LILACS | ID: lil-614990

RESUMO

La enfermedad diverticular duodenal es considerada en el ámbito de la cirugía de vías digestivas como inusual. Por su parte, la complicación menos frecuente referida en la literatura médica lo constituye la perforación aguda, y cuando esta ocurre siempre se practicará tratamiento quirúrgico de urgencia. Resulta polémico llegar a un consenso general que dirija la metodología diagnóstica, debido a su atípica forma de presentación. La tomografía abdominal ha resultado de gran utilidad en el diagnóstico de esta entidad. Se reportan tasas de mortalidad altas (25-30 por ciento) originadas, generalmente, por la dificultad diagnóstica frente a esta enfermedad. Se presenta un nuevo caso de divertículo duodenal perforado en una paciente, del sexo femenino, de 60 años de edad. La técnica quirúrgica empleada en esta oportunidad consistió en la exclusión duodenal y el drenaje del retroperitoneo(AU)


The duodenal diverticular disease is considered within surgery of digestive tracts as unusual. The less frequent complication referred in medical literature is the acute perforation and when it occurs always will be carried out the emergency surgical treatment. It is polemic to arrive to a general consensus directing the diagnostic methodology due to its atypical way of presentation. The abdominal tomography has been very useful in diagnosis of this entity. Authors report high mortality rates (25-30 percent) in general originated by the diagnostic difficulty in face of this disease. A new case of perforated duodenal diverticulum of a female sex patient aged 60. The surgical technique used in this opportunity was the duodenal exclusion and the retroperitoneal drainage(AU)


Assuntos
Humanos , Feminino , Idoso , Abdome Agudo/diagnóstico por imagem , Abdome Agudo/cirurgia , Divertículo Gástrico/cirurgia , Divertículo Gástrico/complicações , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos
17.
Eur Rev Med Pharmacol Sci ; 14(2): 135-8, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20329572

RESUMO

Gastric diverticula are rare disorders which present usually with vague upper abdominal symptoms. The diagnosis is based on endoscopic and radiologic findings, but it may remain uncertain until the operation. Herein we report the case of a 46-year-old woman with a diverticulum of the posterior aspect of the upper part of the gastric fundus, referred to our attention for epigastric pain. The preoperative work out evidenced a pouch of the gastric fundus which was misinterpreted as a paraesophageal or a diaphragmatic hernia. The operation was performed by laparoscopy with a 4-port technique and the diverticulum was resected by an endoscopic stapler. The patient is well and symptom-free more than two months after the operation.


Assuntos
Divertículo Gástrico/cirurgia , Laparoscopia/métodos , Idoso , Feminino , Humanos , Pessoa de Meia-Idade
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