@article {pmid40375540,
year = {2025},
author = {Sakowitz, S and Bakhtiyar, SS and Vadlakonda, A and Aguayo, E and Lee, H and Benharash, P},
title = {Outcomes Following Colectomy at For-Profit Hospitals: A National Analysis.},
journal = {The American surgeon},
volume = {},
number = {},
pages = {31348251337162},
doi = {10.1177/00031348251337162},
pmid = {40375540},
issn = {1555-9823},
abstract = {BackgroundOne of the most commonly performed operations in the US, colectomy remains associated with a substantial incidence of postoperative complications. While there is increasing recognition that hospital for-profit financial structure may be linked with variation in morbidity, the impact of care at for-profit (FP) hospitals on outcomes following colectomy remains to be elucidated.MethodsAll adults undergoing elective/emergent colectomy for diverticular disease, inflammatory bowel disease, benign colonic neoplasms, or colon cancer, ≤2days of admission, were tabulated from the Nationwide Readmissions Database. Patients were stratified by care at FP centers into the FP and Non-FP cohorts. Following entropy balancing, multivariable models were developed to consider the independent association of FP status with key outcomes.ResultsOf ∼1,130,803 admissions for colectomy, 862 495 (76.3%) were elective. Among electively admitted patients, 74 933 (8.7%) were grouped as FP. After risk adjustment, care at FP institutions was associated with greater odds of major morbidity (AOR 1.27, CI 1.22-1.32), non-home discharge (AOR 1.20, CI 1.13-1.27), and non-elective readmission (AOR 1.26, CI 1.12-1.32), but lower per-patient expenditures (β-$2430/patient, CI -2,860, -2010). Considering the 268 308 emergent cases, 38 568 (14.4%) were managed at FP hospitals. Following multivariable adjustment, treatment at FP hospitals remained associated with increased morbidity (AOR 1.16, CI 1.11-1.21) and decreased costs (β-$5,630, CI -6,210, -5,050).DiscussionUndergoing colectomy at FP hospitals was associated with greater complications and readmissions, but reduced per-patient expenditures. Future research should consider the factors contributing to inferior clinical outcomes at these centers. Best practices should be shared across institutions, irrespective of financial structure.},
}

@article {pmid40369874,
year = {2025},
author = {McGrath, IM and Rukins, V and Laisk, T and , and Mortlock, S and Montgomery, GW},
title = {Interaction between genetic risk and comorbid conditions in endometriosis.},
journal = {HGG advances},
volume = {},
number = {},
pages = {100456},
doi = {10.1016/j.xhgg.2025.100456},
pmid = {40369874},
issn = {2666-2477},
abstract = {Endometriosis is a complex disease whereby many genetic and environmental risk factors contribute to disease risk. The genetic risk of endometriosis has been well-characterised in genome-wide association studies. While few physiological risk factors are known, endometriosis is associated with many comorbid disorders. This study examines the interplay between genetic risk factors, comorbid disorders and endometriosis. Genetic and health record data from the UK Biobank (5,432 cases, 92,344 controls) and Estonian Biobank (3,824 cases, 15,296 controls) was used to estimate the correlation between comorbidity burden, endometriosis and genetic risk, as well as to estimate interactive effects between endometriosis PRS and diagnosis of prevalent comorbidities (uterine fibroids, heavy menstrual bleeding, dysmenorrhoea, irritable bowel syndrome, diverticular disease and asthma) on endometriosis prevalence. The comorbidity burden was significantly higher in endometriosis cases and was positively correlated with endometriosis PRS in women without endometriosis but negatively correlated in women with endometriosis. The absolute increase in endometriosis prevalence conveyed by presence of several comorbidities (uterine fibroids, heavy menstrual bleeding, dysmenorrhoea) was greater in individuals with high endometriosis PRS compared to a low endometriosis PRS. These findings, consistent across two biobanks, highlight significant interactions between polygenic risk for endometriosis and the diagnosed comorbidities in endometriosis susceptibility that has implications for understanding the underlying mechanisms contributing to disease risk.},
}

@article {pmid40369270,
year = {2025},
author = {Dalby, HR and Emmertsen, KJ},
title = {Quality of life in diverticular disease: translation and validation of the Danish version of the diverticulitis quality of life instrument (DV‑QOL).},
journal = {International journal of colorectal disease},
volume = {40},
number = {1},
pages = {117},
pmid = {40369270},
issn = {1432-1262},
support = {NNF21OC0071125//Novo Nordisk Fonden/ ; NNF21OC0071125//Novo Nordisk Fonden/ ; },
abstract = {PURPOSE: This study aimed to translate and validate the Danish version of the DV-QOL questionnaire, originally developed in 2015, to assess the impact of diverticular disease on quality of life (QOL) in Danish-speaking patients with diverticulosis.

METHODS: Following international standards, the DV-QOL was translated. A cross-sectional survey was conducted in 2023 with Danish-speaking subjects. The survey included the Danish DV-QOL, an anchor QOL question, and the EuroQol visual analogue scale. Psychometric properties were evaluated for validity, internal consistency, and the ability to identify significant impacts on QOL.

RESULTS: The validation cohort included 16,766 subjects. The DV-QOL score showed a strong correlation with overall QOL (p < 0.001) and high discriminative validity (p < 0.001). Reliability was confirmed with an inter-item correlation of 0.41 and a Cronbach's α of 0.92. The score accurately identified patients with a significant impact of bowel function on QOL, achieving 82% sensitivity and 79% specificity.

CONCLUSION: The Danish DV-QOL is a valid and reliable tool for measuring diverticular disease-specific QOL, beneficial for both clinical and research applications in understanding the impact of the disease and patient outcomes.},
}

@article {pmid40365700,
year = {2025},
author = {Bosch, J and O'Donnell, M and Yi, Q and Moayyedi, P and Alings, M and Avezum, A and Bangdiwala, SI and Barkun, A and Cassella, F and Marchi da Rocha, A and Duzen, I and Enns, R and Forbes, N and Hamilton, L and Kilickap, M and Kruger, P and Liang, Y and Nicolau, JC and Nunes, RB and Oliviera, G and Rey, A and Shofiqul, I and Sun, Y and Vanassche, T and Verhamme, P and Walsh, M and Wang, Z and Wu, C and Zhao, L and Zhu, J and Eikelboom, JW},
title = {Risk factors associated with Gastrointestinal Bleeding in Patients with Cardiovascular Disease (INTERBLEED): a case control study.},
journal = {European journal of preventive cardiology},
volume = {},
number = {},
pages = {},
doi = {10.1093/eurjpc/zwaf300},
pmid = {40365700},
issn = {2047-4881},
abstract = {AIMS: This study aimed to identify and quantify the importance of risk factors for gastrointestinal (GI) bleeding in patients with CV disease.

METHODS: We conducted a case-control study in 9 countries in Asia, America, Europe, and Australia. Cases were patients with CV disease with GI bleeding. Controls were patients with CV without a history of GI bleeding. All participants completed a baseline standardized assessment. We calculated adjusted odds ratios (ORs) and average population attributable fractions (aPAFs) with 95% confidence intervals (CIs).

RESULTS: Between September 2015 and December 2022, we enrolled 2,519 cases and 2,202 controls. Independent risk factors for GI bleeding were age (age 71+: OR 4.16, 95% CI 3.48-4.97; age 61-70: OR 1.69, 95% CI 1.39-2.04; age ≤60 as reference), underweight (OR 3.38, 95% CI 2.24-5.10; aPAF 1.6%, 95% CI 1.0-2.0%), current smoker (OR 1.31; 95% CI 1.09-1.58; aPAF 1.5%, 95% CI 0.6-2.5); chronic kidney disease (OR 1.86, 95% CI 1.62-2.14; aPAF 8.8%, 95% CI 7.0-9.6%), prior stroke (OR 1.56, 95% CI 1.30-1.88, aPAF 2.6%, 95% CI 1.2-4.0%), glucocorticoids (OR 1.71, 95% CI 1.34-2.16, aPAF 1.8%, 95% CI 1.3-2.9%), NSAIDs or COX-2 inhibitors (OR 1.82, 95% CI 1.45-2.29; aPAF 2.2%, 95% CI 1.3-3.0%), liver disease (OR 3.68, 95% CI 2.77-4.89; aPAF 3.5%, 95% CI 2.8-4.2%), peptic ulcer disease (OR 3.38, 95% CI 2.66-4.31; aPAF 4.8%, 95% CI 3.8-5.7%), diverticular disease (OR 1.81, 95% CI 1.46-2.24; aPAF 2.8%, 1.9-3.6%) and antithrombotic therapy within 6 months (aPAF 7.6%, 95% CI 4.3-12.8%). Overall aPAF adjusted for age, sex and region was 37.3% (95% CI 33.0-42.2%).

CONCLUSION: Potentially modifiable risk factors are associated with only about one third of the aPAF for GI bleeding.},
}

@article {pmid40359349,
year = {2025},
author = {Malekout, S and Govindarajah, N and Livingstone, D and Norman, R and Mitchell, R and Farrell-Dillon, K and Belchita, R and Kalasthry, J and Patel, N and Wale, A},
title = {Incidental Findings and Their Significance in Rectal MRI: UK Experience.},
journal = {Topics in magnetic resonance imaging : TMRI},
volume = {34},
number = {1},
pages = {e0317},
doi = {10.1097/RMR.0000000000000317},
pmid = {40359349},
issn = {1536-1004},
mesh = {Humans ; *Incidental Findings ; Male ; *Magnetic Resonance Imaging/statistics & numerical data ; Aged ; Female ; *Rectal Neoplasms/epidemiology/pathology/diagnosis ; United Kingdom/epidemiology ; Middle Aged ; Retrospective Studies ; Aged, 80 and over ; Prevalence ; Adult ; *Rectum/pathology ; Reproducibility of Results ; Sensitivity and Specificity ; },
abstract = {ABSTRACT: Rectal MRI studies used to stage and guide surgical or nonsurgical management of rectal cancer may harbor incidental findings (IFs) of varying significance. St George's Hospital uses a four-sequence MRI protocol which does not employ diffusion-weighted imaging (DW-MRI).

OBJECTIVES: To determine the frequency and significance of incidental findings identified when using a rectal MRI protocol which does not employ DW-MRI.

METHODS: Retrospective analysis of rectal MRI study reports for IFs and stratifying their significance. Medical records were reviewed to clarify IFs of interest.

RESULTS: One hundred thirty-four studies met the inclusion criteria for the study (75 men, mean age 65). 51/134 (38%) of studies had IFs. Fifteen percent (n = 7/46) of baseline studies for a new cancer had significant IFs. The commonest IF was diverticular disease (n = 10); however, a bladder malignancy was also identified.

CONCLUSION: Clinically significant IFs exist in 12% of patients undergoing rectal MRI, and any type of IFs exist in 38% of patients undergoing rectal MRI studies. The rate of significant IFs is comparable with other authors both in rectal and prostate MRI but with fewer overall IFs, possibly due to the lack of DW-MRI sequences in our local protocol. Our study is the first to assess IFs using a rectal MRI protocol which does not employ DW-MRI, and the results should be considered by centers when planning their rectal MRI protocol.},
}

Humans
*Incidental Findings
Male
*Magnetic Resonance Imaging/statistics & numerical data
Aged
Female
*Rectal Neoplasms/epidemiology/pathology/diagnosis
United Kingdom/epidemiology
Middle Aged
Retrospective Studies
Aged, 80 and over
Prevalence
Adult
*Rectum/pathology
Reproducibility of Results
Sensitivity and Specificity

@article {pmid40357078,
year = {2025},
author = {Dadigamuwage, SD and Macaulay, A and Jaufer, M},
title = {Massive Lower Gastrointestinal Bleeding From Colonic Submucosal Lipoma and Diverticular Disease: A Rare Case Requiring Surgical Interventions and Postoperative Management Challenges.},
journal = {Cureus},
volume = {17},
number = {4},
pages = {e82133},
doi = {10.7759/cureus.82133},
pmid = {40357078},
issn = {2168-8184},
abstract = {Massive lower gastrointestinal (GI) bleeding (LGIB) is a life-threatening condition requiring prompt diagnosis and management. While diverticular disease is a common cause, rare entities such as colonic submucosal lipomas may complicate the presentation. This case highlights the diagnostic and therapeutic challenges in managing such a scenario, particularly with recurrent bleeding and postoperative complications. A 61-year-old patient presented with recurrent episodes of massive LGIB over a five-day period. Initial evaluations, including CT angiography and nuclear medicine imaging, identified diverticular disease but failed to localize the bleeding source definitively. Despite receiving 15 units of blood transfusions, the patient experienced persistent bleeding, ultimately necessitating emergency surgery. A right hemicolectomy revealed a submucosal lipoma and diverticular disease in the ascending colon with significant intraluminal hemorrhage. Postoperative management was complicated by pulmonary embolism, requiring therapeutic anticoagulation. This case emphasizes the importance of integrating multiple diagnostic modalities when evaluating massive LGIB, especially in patients with uncommon etiologies. It also highlights the complexities of managing massive transfusion protocols and postoperative thromboembolic events in high-risk patients. This report underscores the need for timely surgical intervention in unresolved cases of massive LGIB and the importance of vigilant postoperative care to prevent complications. Enhanced strategies for early mobilization and hydration are critical for improving outcomes in these patients.},
}

@article {pmid40356947,
year = {2025},
author = {Ambe, PC and Karanikas, M and Sokmen, S},
title = {Editorial: Surgical management of colorectal pathologies.},
journal = {Frontiers in surgery},
volume = {12},
number = {},
pages = {1607005},
doi = {10.3389/fsurg.2025.1607005},
pmid = {40356947},
issn = {2296-875X},
}

@article {pmid40355739,
year = {2025},
author = {Sassun, R and Sileo, A and Ng, JC and Mari, G and Behm, KT and Shawki, SF and Larson, DW},
title = {Diverticular disease complicated by colovesical and colovaginal fistulas: not so complex robotically.},
journal = {Surgical endoscopy},
volume = {},
number = {},
pages = {},
pmid = {40355739},
issn = {1432-2218},
abstract = {INTRODUCTION: Fistulizing diverticulitis occurs in only 2% of diverticular disease cases, but its symptoms, such as urinary tract infections (UTI), pneumaturia, fecaluria, or vaginal discharge, are highly disruptive to patients. Therefore, surgery is commonly recommended. Laparoscopy has been proven feasible and safe for fistulizing diverticulitis, although revealing a conversion rate of 36%. Robotic surgery might reduce the conversion rate due to advanced instrumentation and improved optics.

METHODS: All consecutive patients diagnosed with diverticulitis complicated by a colovesical or/and colovaginal fistula who underwent robotic surgical resection at Mayo Clinic Rochester (January 2018-June 2024) were included. Exclusion criteria were concurrent Crohn's disease, colorectal cancer, isolated coloovarian fistula, and less than one month of follow-up.

RESULTS: Eighty-nine patients were included in the study: fifty-eight (65%) patients presented with a colovesical fistula, 26 (29%) patients with a colovaginal fistula, and 5 (6%) patients with both. Ureteral ICG was utilized in 44% of cases. There were no intraoperative complications and one conversion secondary to loss of planes. Fourteen (16%) and 8 (9%) received an end colostomy or a loop ileostomy, respectively. Overall, 30-days complications were 35%, with anastomotic leak and abscess occurring in 3% and 6% of cases, respectively. One patient experienced a postoperative bladder leak, managed with a Foley catheter for 14 days, leaving no sequelae. With a median follow-up of 16.5 months, one (1%) fistula recurred after 14 days.

CONCLUSIONS: Robotic surgery for fistulizing diverticulitis is feasible, with an acceptable complication rate and extremely low conversion and recurrence rates.},
}

@article {pmid40338318,
year = {2025},
author = {Ono, Y and Gonzalez, RS},
title = {Crypt abscesses, crypt distortion, and crypt rupture may help distinguish inflammatory bowel disease from segmental colitis associated with diverticulosis.},
journal = {Virchows Archiv : an international journal of pathology},
volume = {},
number = {},
pages = {},
pmid = {40338318},
issn = {1432-2307},
abstract = {The histologic distinction of segmental colitis associated with diverticulosis (SCAD) from inflammatory bowel disease (IBD) is difficult; however, distinguishing the two is important for patient management. This study aimed to examine histologic changes in SCAD and compare them to those in IBD. We retrospectively identified patients with highly likely SCAD and known IBD who were biopsied at our institution. With diagnosis blinded, H&E slides were reviewed for cryptitis, crypt abscesses, lamina propria (LP) neutrophils, erosion/ulceration, LP expansion by mononuclear cells, prominent basal lymphoid aggregates, basal lymphoplasmacytosis, crypt distortion, crypt dilation, granulomatous reaction to damaged crypts, increased intraepithelial lymphocytes, mucin depletion, Paneth cell metaplasia, LP smooth muscle wisps, and crypt rupture. Features between groups were compared by chi-squared analysis, with statistical significance set at P < 0.05. There were 81 SCAD cases (79% in the sigmoid colon) and 166 IBD cases. A separate cohort of 27 patients had both IBD and diverticulosis. Compared to the IBD cohort, the SCAD cohort was significantly less likely to demonstrate crypt abscesses (20% vs. 45%, P < 0.0001), prominent basal lymphoid aggregates (37% vs. 51%, P = 0.042), crypt distortion (7% vs. 25%, P = 0.00090), Paneth cell metaplasia (37% vs. 57%, P = 0.0061), and crypt rupture (1% vs. 11%, P = 0.0089). These histologic features, although not entirely specific, may be of value in distinguishing IBD from SCAD, particularly when clinical context is unclear or not readily available.},
}

@article {pmid40330996,
year = {2025},
author = {Lu, A and Sambandam, S and Gadda, M and Ratcliff, T and Huerta, S},
title = {Risk Factors and Outcomes Associated with Emergency Abdominal Surgery following Lower Extremity Total Joint Arthroplasty.},
journal = {The archives of bone and joint surgery},
volume = {13},
number = {4},
pages = {196-203},
pmid = {40330996},
issn = {2345-4644},
abstract = {OBJECTIVES: This study aims to identify potential risk factors and assess postoperative outcomes associated with requiring emergency abdominal surgery (EAS) within 30 days following total hip arthroplasty (THA) and total knee arthroplasty (TKA). We hypothesized that patients requiring EAS would carry a higher morbidity and mortality rates compared to patients that underwent the index operation alone.

METHODS: We conducted a retrospective analysis using TriNetX, examining data from 2016-2024 from patients over 18 years old who underwent THA/TKA and required EAS within 30 days. Postoperative outcomes, including mortality and hospital readmission, were compared between patients requiring EAS and those who did not. Statistical analyses included measures of association and chi-squared tests. Patient demographic data, including age, sex, and comorbidities were analyzed.

RESULTS: Patients requiring EAS within 30 days of a joint arthroplasty were significantly more likely to be older, overweight or obese, and to be diagnosed with comorbidities including diverticular disease, cholelithiasis, alcohol use disorders, and tobacco use. These patients had significantly higher mortality rates within 60 days of joint arthroplasty compared to patients without EAS, suggesting that the second operation contributed significantly to the increase in adverse outcomes.

CONCLUSION: This study emphasizes the importance of recognizing key risk factors for severe GI complications that require EAS. These findings highlight the need for careful patient selection, pre-operative evaluation of risk, and vigilant post-operative management, especially in those with many risk factors. Improved identification and management of high-risk patients may help reduce the likelihood of EAS and its associated mortality.},
}

@article {pmid40330635,
year = {2025},
author = {Kühn, F and Bianchi, PP},
title = {Current Role of Robotic Surgery in Colorectal Disease.},
journal = {Visceral medicine},
volume = {},
number = {},
pages = {1-7},
pmid = {40330635},
issn = {2297-4725},
abstract = {BACKGROUND: Robot-assisted surgery aims to combine the advantages of open surgery with those of minimally invasive surgery to overcome the previous limitations of laparoscopy. Compared to conventional laparoscopic methods, robot-assisted techniques offer significant advantages, which are currently increasingly employed despite mostly longer operating times and higher costs. The aim of this review was to describe the current role of robotics in the treatment spectrum of colorectal surgery.

SUMMARY: A comprehensive literature review was conducted using PubMed, Medline, and Embase to identify studies, systematic reviews, and meta-analyses on robotic surgery for colorectal benign and malignant disease, focusing on studies and meta-analyses comparing the laparoscopic with the robotic approach; articles published between 2004 and 2024 were screened: results of studies on surgical techniques must always be interpreted with caution, taking into account the technical skills and preferences of the participating surgeons. Compared to conventional laparoscopic methods and independent of the indication, robot-assisted techniques offer obvious technical and ergonomic advantages. Most colorectal procedures can safely be conducted via robotic-assisted surgery. Throughout the various indications described in this manuscript, the most evident advantage of robotic surgery remains a lower conversion rate, followed by less blood loss and a shorter hospital stay at the price of a longer operating time. For malignant disease, robotic surgery seems to be additionally associated with a higher lymph node yield in the majority of the studies. In acute or chronic inflammatory colorectal diseases, robotic-assisted surgery may facilitate interventions through improved visibility and a potentially more precise dissection of the correct plane; furthermore, robotic-assisted surgery offers advantages for performing complex intracorporal anastomoses. Last but not least, the surgeon's well-being and preferences make a relevant impact on the utilization of the system in colorectal surgery.

KEY MESSAGES: The use of robot-assisted procedures has increased significantly in the last decade across the various surgical specialties, with the largest increase in colorectal surgery. Next to the surgeons' preferences, capacity and costs will define the future role of robotic surgery in colorectal disease. As robotic surgery is becoming a mainstream surgical approach, there is a crying need for implementable training concepts of robotic techniques in colorectal surgery.},
}

@article {pmid40326086,
year = {2025},
author = {Wrona, A and Dziedzic, M and Gliwa, J and Bonczar, M and Ostrowski, P and Wojciechowski, W and Walocha, JA and Koziej, M},
title = {The sigmoid arteries - an imaging-based anatomical study with clinical implications.},
journal = {Folia morphologica},
volume = {},
number = {},
pages = {},
doi = {10.5603/fm.105194},
pmid = {40326086},
issn = {1644-3284},
abstract = {BACKGROUND: The sigmoid arteries (SAs) are essential for supplying blood to the sigmoid colon and exhibit considerable anatomical variability in their number, origin, and branching patterns. A precise understanding of SA anatomy is crucial for colorectal surgical procedures, particularly in oncological and diverticular disease resections.

MATERIALS AND METHODS: A retrospective analysis was performed on 75 consecutive Polish patients who underwent abdominal computed tomography angiography (CTA) at the Radiology Department of Jagiellonian University Medical College between 2018 and 2022. The study assessed SA origin, diameter, cross-sectional area, and distance from the inferior mesenteric artery (IMA).

RESULTS: The first SA most commonly originated directly from the IMA (69.01%), whereas the second and third SAs predominantly arose from the sigmoid trunk. The analysis of SA types, based on the Cirocchi et al. classification, revealed that Type 1 configurations were the most common, accounting for 50.70% of cases. Among them, Type 1B was the predominant subtype (35.21%). The median number of observed SAs per patient was 1, with a maximum of 6. The first SA had a median diameter of 1.97 mm at its origin, with a range from 0.70 mm to 3.32 mm. The distance from the origin of the IMA to the first SA exhibited a wide range, with a median of 52.76 mm and a maximum of 82.77 mm.

CONCLUSIONS: The sigmoid arteries, which serve as the primary source of blood supply to the sigmoid colon, exhibit significant variability in their origin and number of branches. The present study provides a detailed and comprehensive analysis of the morphometric characteristics and branching patterns of the sigmoid arteries, aiming to enhance current knowledge. This data may be particularly valuable for physicians, as it is clinically relevant to various colorectal surgical procedures, such as malignancy resections.},
}

@article {pmid40316749,
year = {2025},
author = {Sheehan, E and Brockhaus, KK and Huebner, M and Ma, W and Kolli, N and Cleary, RK},
title = {Risk factors for ileus after enhanced recovery robotic colectomy mediated by postoperative opioids: a single institution analysis.},
journal = {Surgical endoscopy},
volume = {},
number = {},
pages = {},
pmid = {40316749},
issn = {1432-2218},
abstract = {BACKGROUND: Postoperative ileus (POI) after colorectal surgery is associated with prolonged hospital length of stay, readmission, and higher costs of care. POI may be unpredictable and even uncomplicated enhanced recovery elective minimally invasive colorectal operations may be complicated by ileus and readmission related to ileus. Determining if there are modifiable factors associated with ileus may suggest quality improvement interventions designed to decrease ileus. The aim of this study was to identify patient characteristics associated with ileus and the relationship with postoperative opioids.

METHODS: This is a single institution retrospective analysis of robotic right and left colectomy in a prospectively maintained institutional colorectal surgery database from 1/1/2018 to 7/31/2024. The primary outcome was postoperative ileus. Mediation analysis was used to examine the association of patient factors with ileus mediated by postoperative opioids.

RESULTS: There were 394 left and 267 right colectomies that met inclusion criteria. Neoplasia was the operative diagnosis for 89.5% of right colectomies and diverticular disease for 78.7% of left colectomies (p < 0.001). Median postoperative hospital length of stay was 2.0 days. Ileus occurred in 5.6% of the patient population. An analysis with postoperative opioids (intravenous or oral) as mediating variable showed that postoperative opioids were associated with ileus (OR 2.83, CI 1.18-14.67). While older patients had less opioid requirements (OR 0.96, CI 0.95-0.98), the risk of ileus (OR 1.03, CI 1.00-1.06) was the same for older patients with and without opioids. A decrease in opioid prescriptions at discharge was seen over time (p < 0.001).

CONCLUSION: Postoperative opioids were the only modifiable risk factor for ileus after robotic segmental colectomy. The risk of ileus for other factors associated with ileus did not increase when opioids were added postoperatively. Considering other opioid-sparing enhanced recovery pathway options and increased adoption of the minimally invasive surgical approach may lessen this vexing postoperative complication.},
}

@article {pmid40312905,
year = {2025},
author = {Costa, PHP and Rodrigues, P and Takemura, LS and Germano, MA and Sales, MES and de Paulo, GA and Bianco, B and Lemos, MB and Lemos, GC and Carneiro, A},
title = {Neural crosstalk and symptom overlap: The correlation between urinary and intestinal symptoms in patients undergoing colonoscopy.},
journal = {Investigative and clinical urology},
volume = {66},
number = {3},
pages = {251-260},
doi = {10.4111/icu.20240377},
pmid = {40312905},
issn = {2466-054X},
mesh = {Humans ; Male ; Middle Aged ; Cross-Sectional Studies ; Female ; *Colonoscopy ; *Lower Urinary Tract Symptoms/physiopathology/diagnosis ; Aged ; Adult ; *Urinary Bladder, Overactive/physiopathology/diagnosis ; Surveys and Questionnaires ; },
abstract = {PURPOSE: Neural crosstalk in the pelvis involves intrinsic communication networks among pelvic structures that direct afferent inputs to converge on neurons, leading to viscerovisceral and somatovisceral reflexes. We aimed to explore the overlap between intestinal and urinary symptoms and their correlations in patients undergoing colonoscopy.

MATERIALS AND METHODS: Cross-sectional study with 167 participants who underwent colonoscopy and were assessed using three self-administered questionnaires: the International Prostate Symptom Score (IPSS) for lower urinary tract symptoms, the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) for overactive bladder symptoms, and the Gastrointestinal Symptom Rating Scale (GSRS) for gastrointestinal (GI) symptoms.

RESULTS: Among the participants, 55.1% were male, and the median age was 57 years. Most colonoscopies (80.8%) were performed for screening, and the most common finding was diverticular disease (DD) (35.9%). The IPSS and ICIQ-OAB were strongly correlated (rho=0.544, p<0.001), while the IPSS and GSRS scores showed a moderate correlation (rho=0.304, p<0.001). In the DD subgroup, both ICIQ-OAB and IPSS (rho=0.568, p<0.001), and IPSS and GSRS (rho=0.493, p<0.001) showed strong correlations. In contrast, the subgroup without DD showed a strong correlation between the ICIQ-OAB and IPSS (rho=0.510, p<0.001), but only a weak correlation between the IPSS and GSRS (rho=0.188, p=0.057), suggesting that the urinary-GI connection is influenced by the presence of DD.

CONCLUSIONS: The findings revealed intrinsic relationships between urinary and GI symptoms, with DD as a significant factor influencing these relationships, suggesting that a more integrated approach to evaluate and manage these patients can potentially improve diagnostic accuracy and treatment outcomes.},
}

Humans
Male
Middle Aged
Cross-Sectional Studies
Female
*Colonoscopy
*Lower Urinary Tract Symptoms/physiopathology/diagnosis
Aged
Adult
*Urinary Bladder, Overactive/physiopathology/diagnosis
Surveys and Questionnaires

@article {pmid39752564,
year = {2025},
author = {Wang, Y and Zhao, Z and Wang, R and Hu, X},
title = {Genetic Links between Gastrointestinal Disorders and Kidney Stone Disease: Insights from a Genome-Wide Cross-Trait Analysis.},
journal = {Kidney360},
volume = {6},
number = {4},
pages = {616-626},
pmid = {39752564},
issn = {2641-7650},
abstract = {KEY POINTS: Positive genetic links and shared genetic architecture exist between gastrointestinal disorders and kidney stone disease. Ion homeostasis and response to vitamin D bridge two types of disorders. Genetically predicted irritable bowel syndrome, gastroesophageal reflux, and Crohn's disease were associated with higher risk of kidney stone disease.

BACKGROUND: Epidemiological associations between kidney stone disease (KSD) and gastrointestinal disorders have been reported, and intestinal homeostasis plays a critical role in stone formation. However, the underlying intrinsic link is not adequately understood. This study aims to investigate the genetic associations between these two types of diseases.

METHODS: We obtained summary statistics from large-scale genome-wide association studies of KSD and gastrointestinal diseases, including gastroesophageal reflux disease, peptic ulcer disease, inflammatory bowel disease and its subtypes, irritable bowel syndrome, and diverticular disease (N=311,254–720,199). Their overall genetic correlations were first estimated. We then detected the shared genetic architecture, including pleiotropic single nucleotide polymorphisms, loci, genes, and biological processes, through cross-trait analyses. In addition, bidirectional Mendelian randomization analysis was performed to look for their causal relationships.

RESULTS: We found significantly positive genetic correlations between KSD and all five gastrointestinal diseases. The cross-trait analysis identified 3184 potential pleiotropic single nucleotide polymorphisms, and 33 of which were pleiotropic loci shared by the two disorders. Gene-level analyses revealed eight pleiotropic causal genes, primarily enriched in biological pathways involving ion homeostasis and response to vitamin D. In the Mendelian randomization analysis, we detected causal effects from gastroesophageal reflux disease, irritable bowel syndrome, and Crohn's disease to KSD, while no reverse causality was observed.

CONCLUSIONS: Our study demonstrated the positive genetic links between KSD and gastrointestinal diseases and reported pleiotropic variants, loci, and genes, implicating potential biological mechanisms in the pathogenesis of stone disease. These findings further support the role of the gut-kidney axis and provide a genetic basis for the prevention, coregulation, and treatment of these diseases.},
}

@article {pmid40303443,
year = {2025},
author = {Rebic, AD and Souza, DLS and Fellner, AN and Guend, H},
title = {Robotic Management of Diverticular Colovaginal and Colovesical Fistulas.},
journal = {JSLS : Journal of the Society of Laparoendoscopic Surgeons},
volume = {29},
number = {2},
pages = {},
pmid = {40303443},
issn = {1938-3797},
mesh = {Humans ; Female ; *Robotic Surgical Procedures/methods ; Retrospective Studies ; Middle Aged ; *Intestinal Fistula/surgery/etiology ; Aged ; *Vaginal Fistula/surgery/etiology ; Laparoscopy/methods ; Operative Time ; Treatment Outcome ; Adult ; Postoperative Complications/epidemiology ; Conversion to Open Surgery/statistics & numerical data ; },
abstract = {BACKGROUND AND OBJECTIVES: Colovesical and colovaginal fistulas are a complication of diverticular disease that often requires surgical intervention. Minimally invasive surgery is associated with improved postoperative outcomes, but reported laparoscopic rates of conversion to open for these patients have been relatively high. There are limited studies evaluating robotic-assisted management of these fistulas. This study aims to report our single-center experience of robotic management of such fistulas, with the primary outcome being the conversion rate to open.

METHODS: All elective robotic sigmoid resections for diverticular colovaginal and colovesical fistulas performed from January 2018 to August 2023 were included. Patient demographic variables and 30-day postoperative outcomes were retrospectively collected.

RESULTS: Thirty-five patients were included, 21 with colovesical and 14 with colovaginal fistulas. Overall, the conversion to open rate was 8.6% (3 out of 35). All patients converted to open were patients with colovesical fistulas. Operating time (median of 354 vs 347 minutes, P = .583) and estimated blood loss (median of 100 vs 100 mL, P = .538) were similar for colovesical and colovaginal fistulas, respectively. Two patients required ostomy creation, both in the colovaginal group. Three patients in the colovesical group developed an ileus compared to one in the colovaginal group. There were 2 urinary tract infections (UTIs), both in the colovesical group. Thirty-day readmission (2 vs 1, P = .652) and length of stay (median 2 vs 2 days, P = .855) were similar for colovesical and colovaginal fistulas, respectively.

CONCLUSION: Diverticular fistulas can be managed successfully with a robotic approach and appropriate surgeon experience, having minimal morbidity or complications.},
}

Humans
Female
*Robotic Surgical Procedures/methods
Retrospective Studies
Middle Aged
*Intestinal Fistula/surgery/etiology
Aged
*Vaginal Fistula/surgery/etiology
Laparoscopy/methods
Operative Time
Treatment Outcome
Adult
Postoperative Complications/epidemiology
Conversion to Open Surgery/statistics & numerical data

@article {pmid40279471,
year = {2025},
author = {Ávalos-Herrera, VJ and Borunda-Escudero, GE and Núñez-Cabrera, JE and Rizo-Guzmán, L and Gómez-Arciniega, KD},
title = {[Jejunal diverticular disease: a rare cause of gastrointestinal bleeding].},
journal = {Revista medica del Instituto Mexicano del Seguro Social},
volume = {63},
number = {2},
pages = {e6421},
doi = {10.5281/zenodo.14617208},
pmid = {40279471},
issn = {2448-5667},
abstract = {BACKGROUND: Digestive bleeding is an important cause of hospital admission; however, the mortality rate in these patients has not been reduced. Digestive bleeding has a multiple etiology; specifically, bleeding from the small intestine accounts for 5 to 10% of gastrointestinal hemorrhages, of which between 0.06% and 5% of cases are caused by diverticula of the small intestine. Most cases are asymptomatic; however, the symptomatic form is highly variable and can present with multiple complications, such as massive bleeding. Therefore, the objective of this study was to explore the approach to jejunal diverticular disease (JDD) with gastrointestinal bleeding.

CLINICAL CASE: A 48-year-old male patient presented with massive digestive bleeding of unknown origin, initially treated with angiography and embolization, with a satisfactory outcome. However, six days after discharge, the patient experienced new massive bleeding that required an urgent exploratory laparotomy, during which jejunal diverticular disease (JDD) of the small intestine was identified.

CONCLUSIONS: Diverticula of the small intestine are usually asymptomatic, and complications are rare; however, they can affect the patient's survival. Therefore, an appropriate approach, accurate and timely diagnosis, and a multidisciplinary management strategy are required to offer the best therapeutic options for the patient.},
}

@article {pmid40212861,
year = {2025},
author = {Patel, A and Bhushan, S},
title = {Recurrent Diverticulitis Complicated by Actinomyces turicensis Abscess.},
journal = {ACG case reports journal},
volume = {12},
number = {4},
pages = {e01658},
pmid = {40212861},
issn = {2326-3253},
abstract = {Actinomyces turicensis is an uncommon cause of intra-abdominal infection. We present a patient with diverticulitis complicated by A. turicensis abscess formation. Our patient required multiple admissions and a prolonged course of antibiotics. To our knowledge, this case represents the first instance of A. turicensis complicating diverticular disease. This case highlights the challenges in managing Actinomycotic infections and will hopefully prompt clinicians to consider atypical pathogens in other cases of refractory diverticulitis.},
}

@article {pmid40202732,
year = {2025},
author = {Myers, S and Davids, JS},
title = {LASER Focus on Long-Term Outcomes for Diverticular Disease.},
journal = {JAMA surgery},
volume = {},
number = {},
pages = {},
doi = {10.1001/jamasurg.2025.0615},
pmid = {40202732},
issn = {2168-6262},
}

@article {pmid40201108,
year = {2025},
author = {Schardey, J and von Ahnen, T and Crispin, A and Knoblauch, M and Zimmermann, P and Kühn, F and Andrassy, J and Werner, J and Rau, BM and Wirth, U},
title = {Efficacy of a Shortened Oral Antibiotic Bowel Decontamination in Minimally Invasive Surgery for Diverticular Disease.},
journal = {Visceral medicine},
volume = {41},
number = {2},
pages = {92-99},
pmid = {40201108},
issn = {2297-4725},
abstract = {INTRODUCTION: Infectious complications, such as anastomotic leakage (AL) and surgical site infections (SSIs), remain a significant challenge in colorectal surgery. Consequently, there is growing interest in oral antibiotic bowel decontamination with nonabsorbable antibiotics (selective digestive decontamination or SDD), which can reduce perioperative complications while also minimizing antibiotic use. This study aimed to determine whether a 3-day SDD regimen is as effective as a 7-day regimen in preventing postoperative complications in laparoscopic diverticular surgery.

METHODS: A bicenter data analysis of prospectively and retrospectively collected patient data was performed. A 3-day versus 7-day perioperative use of an SDD-based regimen (polymyxin B, gentamicin, vancomycin, and amphotericin B) in patients undergoing minimally invasive surgery for diverticular disease was compared using noninferiority analysis.

RESULTS: A total of 469 patients were included in the analysis: 101 patients received a 3-day perioperative SDD regimen, while 368 patients received a 7-day regimen. Due to the use of routine clinical data, no control cohort is available. The overall complication rate was 16.5% in both groups. AL and SSI occurred in 2.0% and 6.0% of the 3-day group, and in 1.4% and 6.3% of the 7-day group, respectively, with no significant differences between the groups. However, for wound infections and overall infectious complications, the 3-day regimen can be considered noninferior to the 7-day regimen. Our data did not confirm the noninferiority of the SDD3 regimen compared to the SDD7 regimen for AL.

DISCUSSION: We report low rates of AL and other surgical and nonsurgical complications in minimally invasive diverticular disease surgery. The low complication rates demonstrate noninferiority regarding SSI. Our findings are consistent with recent evidence, highlighting the positive impact of perioperative SDD treatment on SSI and infectious complications.},
}

@article {pmid40196262,
year = {2025},
author = {Neylan, CJ and Levin, MG and Hartmann, K and Beigel, K and Khodursky, S and DePaolo, JS and Abramowitz, S and Furth, EE and Heuckeroth, RO and Damrauer, SM and Maguire, LH},
title = {Genome-wide association meta-analysis identifies 126 novel loci for diverticular disease and implicates connective tissue and colonic motility.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
pmid = {40196262},
support = {K08 DK124687/DK/NIDDK NIH HHS/United States ; UL1 TR001878/TR/NCATS NIH HHS/United States ; IK2 CX001780/CX/CSRD VA/United States ; R01 DK128282/DK/NIDDK NIH HHS/United States ; TL1 TR001880/TR/NCATS NIH HHS/United States ; },
abstract = {Diverticular disease is a common and morbid complex phenotype influenced by both innate and environmental risk factors. We performed the largest genome-wide association study meta-analysis for diverticular disease, identifying 126 novel loci. Employing multiple downstream analytic strategies, including tissue and pathway enrichment, statistical fine-mapping, allele-specific expression, protein quantitative trait loci and drug-target investigations, and linkage disequilibrium score regression, we prioritized causal genes and produced several lines of evidence linking diverticular disease to connective tissue biology and colonic motility. We substantiated these findings by integrating single-cell RNA sequencing data, showing that prioritized diverticular disease-associated genes are enriched for expression in colonic smooth muscle, fibroblasts, and interstitial cells of Cajal. In quantitative analysis of surgical specimens, we found a substantial reduction in the density of elastin present in the sigmoid colon in severe diverticulitis.},
}

@article {pmid40195019,
year = {2025},
author = {Mirande, MD and Bews, KA and Brady, JT and Colibaseanu, DT and Shawki, SF and Perry, WR and Behm, KT and Mathis, KL and McKenna, NP},
title = {Does timing of ileostomy closure impact postoperative morbidity?.},
journal = {Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland},
volume = {27},
number = {4},
pages = {e70088},
doi = {10.1111/codi.70088},
pmid = {40195019},
issn = {1463-1318},
mesh = {Humans ; *Ileostomy/adverse effects/methods ; Female ; Retrospective Studies ; Male ; Middle Aged ; *Postoperative Complications/etiology/epidemiology ; Time Factors ; Aged ; Adult ; },
abstract = {AIM: Reversal of diverting loop ileostomy (DLI) traditionally occurs at ≥12 weeks after formation. Early closure has been performed in attempts to reduce DLI-associated morbidity. Therefore, the aim of this study was to determine whether time to stoma reversal impacts postoperative morbidity.

METHOD: A retrospective review was conducted using institutional-level American College of Surgeons National Surgical Quality Improvement Program data for adult patients who underwent DLI closure between January 2012 and December 2021 across a multistate health system. Time to DLI closure was stratified into three groups: ≤12, 12-24 or 24-36 weeks. Additional data were obtained from the electronic medical record. The primary outcome was major morbidity after DLI closure.

RESULTS: A total of 482 patients underwent DLI closure. Eighty four patients underwent closure at ≤12 weeks (17.4%), 300 at 12-24 weeks (62.2%) and 98 at 24-36 weeks (20.3%). The most common diagnosis at DLI formation was cancer (n = 211, 43.8%). Patients in the ≤12 weeks closure group more commonly had ulcerative colitis or diverticular disease and a lower American Society of Anesthesiologists class than patients with closure at 24-36 weeks (p < 0.05). There were no significant differences in complication severity, overall major morbidity or its individual components amongst the time to DLI closure groups. There were no differences in anastomotic leaks or need for laparotomy. On multivariable analysis, immunosuppressive therapy and preoperative haematocrit <30% were significant risk factors for major morbidity after DLI closure.

CONCLUSION: Major morbidity did not differ by time to DLI closure group, indicating that closure at ≤12 weeks is safe in selected patients.},
}

Humans
*Ileostomy/adverse effects/methods
Female
Retrospective Studies
Male
Middle Aged
*Postoperative Complications/etiology/epidemiology
Time Factors
Aged
Adult

@article {pmid40191509,
year = {2025},
author = {Piotrowicz, G and Ossowska-Dorosz, B and Dorosz, Ł and Kaszubowski, MF and Małgorzewicz, S and Stępień, B and Rudnik, A and Synowiecka, A and Rydzewska, G},
title = {Managing diverticula: dietary changes for a more comfortable life.},
journal = {Przeglad gastroenterologiczny},
volume = {20},
number = {1},
pages = {92-101},
pmid = {40191509},
issn = {1895-5770},
abstract = {INTRODUCTION: Diverticulosis is an anatomical condition with increasing incidence. Diverticula are common findings during screening colonoscopies, making diagnosis and treatment challenging in routine clinical practice. Nutritional factors have been identified as significant risk factors, and it has been suggested that diets recommended for the prevention of cardiovascular and other chronic diseases may also positively influence the clinical course of diverticulosis.

AIM: To analyse dietary patterns in various groups of patients with diverticular disease and to identify potential differences that may affect the types of symptoms presented.

MATERIAL AND METHODS: A group of 100 patients, including 71 women and 29 men aged 40 to 90 years, were analysed using the FFQ-6 form and a 24-hour nutritional interview. The most common condition among individuals with diverticulosis was symptomatic uncomplicated diverticular disease (SUDD), which occurred with similar frequency in both sexes.

RESULTS: Analysis of dietary components revealed higher fat intake in the SUDD group and reduced vitamin E consumption, particularly in the group with segmental colitis associated with diverticulosis (SCAD). Additionally, there was a significant reduction in the intake of calcium, magnesium, and zinc across all analysed groups, along with a nearly one-third reduction in dietary fibre intake.

CONCLUSIONS: Based on the nutritional data, the factors that may contribute to the development of diverticular disease include high intake of animal protein, fat, cholesterol, deficiencies in microelements such as zinc, excess sodium, and excessive consumption of B vitamins, particularly vitamin B6.},
}

@article {pmid40186629,
year = {2025},
author = {Altıner, S and Aydoğdu, YF and Kosmaz, K and Durhan, A and Senlikci, A and Suleyman, M and Ersak, C and Pekcici, MR},
title = {The association between colonic diverticulosis and colorectal polyps in a retrospective cohort study.},
journal = {International journal of colorectal disease},
volume = {40},
number = {1},
pages = {88},
pmid = {40186629},
issn = {1432-1262},
mesh = {Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; *Colonic Polyps/complications ; *Diverticulosis, Colonic/complications ; Risk Factors ; Aged ; Colorectal Neoplasms ; Adult ; Colonoscopy ; Age Factors ; },
abstract = {OBJECTIVE: This study aimed to investigate the relationship between colonic diverticulosis, colorectal polyps, and colorectal cancer.

MATERIAL AND METHODS: A total of 648 patients (275 females, 373 males) who underwent complete colonoscopy between January 2016 and June 2020 were retrospectively analyzed. The presence and localization of diverticula, polyps, and cancer were recorded, and the association between diverticular disease and the formation of polyps and cancer was evaluated.

RESULTS: Diverticula were identified in 53 patients (8.2%), while 595 patients (91.8%) had no diverticula. Polyps were detected in 148 patients (22.8%), and no polyps were found in 500 patients (77.2%). Adenocarcinoma was diagnosed in 67 patients (10.3%), with no malignancy observed in 581 patients (89.7%). The mean age of patients with polyps was 59.5 years, compared to 53.3 years in those without polyps (p < 0.001). Multivariate logistic regression analysis revealed that diverticulum status did not significantly influence the risk of polyp formation, whereas advanced age was identified as a significant risk factor (p < 0.001).

CONCLUSION: Advanced age is a significant risk factor for colorectal polyp formation, whereas diverticulosis is not an independent risk factor. These findings highlight the importance of age-based screening strategies for colorectal neoplasia.},
}

Humans
Male
Female
Middle Aged
Retrospective Studies
*Colonic Polyps/complications
*Diverticulosis, Colonic/complications
Risk Factors
Aged
Colorectal Neoplasms
Adult
Colonoscopy
Age Factors

@article {pmid40182848,
year = {2025},
author = {Papagrigoriadis, S and Brandimarte, G and Tursi, A},
title = {Fistulating diverticulitis: a distinct clinical entity?.},
journal = {Frontiers in medicine},
volume = {12},
number = {},
pages = {1500053},
pmid = {40182848},
issn = {2296-858X},
abstract = {INTRODUCTION: Diverticular disease (DD) of the colon has a number of phenotypes, including asymptomatic diverticulosis and complicated diverticulitis with bowel perforation or bleeding. The factor that affects the phenotype of this condition and leads to a wide range of clinical presentations is unknown. The formation of fistulas associated with diverticulitis has long been recognized, and they are treated according to ad hoc indications. We hypothesized that the formation of fistulas in diverticular disease exhibits such a wide range of variable anatomic features that it may be considered a distinct form of the condition, fistulating diverticulitis (FD).

METHODS: We conducted a narrative review based on 50 years of publications covering a wide range of diverticulitis-associated fistulas, both common and uncommon.

RESULTS: While there is abundant literature on common fistulas, such as colovesical and colovaginal fistulas, little is known about rarer fistulas, such as coloenteric fistulas, colocutaneous fistulas, and genitourinary tract fistulas. The majority of these fistulas are treated surgically, which is in contrast to the trend toward conservative management that is predominant in acute or chronic diverticulitis.

DISCUSSION: Epidemiological and histological evidence support the hypothesis that FD may be a feature of chronic DD that requires individual management. Histopathology shows similarities with Crohn's disease. It remains unknown which underlying immune or genetic factors may be affecting the clinical presentation of these patients, leading to fistulation. We contend that there is adequate published evidence to characterize a distinct phenotype of FD that can involve the entire GI tract and other organs. Surgical guidelines may need to be modified to treat this small but important group, which predominantly requires surgical treatment.},
}

@article {pmid40182832,
year = {2025},
author = {Murdock, PMW and Venero, AC and Heidel, RE and Hale, BW and Russ, AJ},
title = {Laparoscopic Versus Robotic Elective Sigmoid Resection for Complicated Diverticulitis.},
journal = {JSLS : Journal of the Society of Laparoendoscopic Surgeons},
volume = {29},
number = {1},
pages = {},
pmid = {40182832},
issn = {1938-3797},
mesh = {Humans ; *Robotic Surgical Procedures/methods ; *Laparoscopy/methods ; Male ; Female ; Retrospective Studies ; Middle Aged ; *Colectomy/methods ; *Elective Surgical Procedures/methods ; Aged ; Operative Time ; *Colon, Sigmoid/surgery ; *Diverticulitis, Colonic/surgery/complications ; Treatment Outcome ; Length of Stay/statistics & numerical data ; Postoperative Complications/epidemiology ; Adult ; Blood Loss, Surgical/statistics & numerical data ; Reoperation/statistics & numerical data ; },
abstract = {OBJECTIVE: Minimally invasive surgical techniques for colorectal surgery have continued to grow in prevalence with robotic surgery potentially providing advantages in complex pelvic operations. We sought to examine the outcomes of laparoscopic versus robotic elective sigmoid colon resection for complicated diverticulitis.

METHODS: We performed a retrospective review of patients at an academic tertiary care center from 2018-2023 who underwent elective minimally invasive sigmoid colon resections for complicated diverticulitis. Multiple regression analysis was performed with primary outcomes being reoperation within 30 days and overall complications. Secondary outcomes included conversion to open, estimated blood loss, operative time, days until return of bowel function, and length of stay.

RESULTS: In this cohort of 131 patients, 38 underwent laparoscopic colectomy and 93 patients underwent robotic colectomy. There were no significant differences between rate of reoperation (7.7% vs 2.1%, P = .42), complications (5.1% vs 8.4%, P = .52), conversion to open (5.1% vs 2.1%, P = .25), days until return of bowel function (1.87 vs 2.01, P = .41), or length of stay (5.2 vs 5.2, P = .92). There were significant differences in operative time and estimated blood loss. Robotic approach was 128.11 minutes longer (β = 128.11, SE = 12, p < .001) and had 33.4 cc less estimated blood loss (β = -33.4, SE = 16.6, P = .046), when adjusting for other confounders.

CONCLUSION: Robotic sigmoid colectomy for complicated diverticulitis had mostly equivalent outcomes at this institution. There was some decrease in estimated blood loss, however, operative time was increased in the robotic group.},
}

Humans
*Robotic Surgical Procedures/methods
*Laparoscopy/methods
Male
Female
Retrospective Studies
Middle Aged
*Colectomy/methods
*Elective Surgical Procedures/methods
Aged
Operative Time
*Colon, Sigmoid/surgery
*Diverticulitis, Colonic/surgery/complications
Treatment Outcome
Length of Stay/statistics & numerical data
Postoperative Complications/epidemiology
Adult
Blood Loss, Surgical/statistics & numerical data
Reoperation/statistics & numerical data

@article {pmid40140081,
year = {2025},
author = {Mui, J and Sarofim, M and Cheng, E and Gilmore, A},
title = {Laparoscopic natural orifice specimen extraction for diverticular disease: a systematic review.},
journal = {Surgical endoscopy},
volume = {},
number = {},
pages = {},
pmid = {40140081},
issn = {1432-2218},
abstract = {BACKGROUND: Diverticular disease is extremely common in the Western world, with a proportion of complications requiring colonic resection. Whilst laparoscopic surgery has its benefits, a large wound for specimen extraction predisposes to surgical site infection, prolonged pain and prolonged hospital admission. Natural orifice specimen extraction (NOSE) is an alternative technique that has not yet been widely adopted in diverticular disease surgery. The aim of this systematic review is to evaluate the evidence on the outcomes of NOSE in left sided resections for diverticular disease.

METHODS: A systematic review of PubMed, Ovid MEDLINE and EMBASE was performed to identify studies that reported outcomes for left sided resections with NOSE in diverticular disease. The studies reviewed were all human studies published in a peer-reviewed journal after 2010. The participants had to be over the age of 18 and the extraction site had to be transanal/transrectal. Articles that were not full text or not in English were excluded. These studies were assessed independently by two reviewers using a standardised pre-piloted form.

RESULTS: One hundred and eighty-seven articles were screened, with 9 articles meeting the inclusion criteria. The study sample size ranged from 8 to 157 participants, with a pooled total of 428 patients who had NOSE. Hospital length of stay varied from 4 to 6 days. Only 2 patients required conversion to transabdominal extraction. Pain scores were lower post-NOSE compared to traditional abdominal extraction in 2 out of 3 studies. The anastomotic leak rate varied from 0 to 18%. Six studies reported no surgical site infections and there was only 1 mortality.

CONCLUSION: NOSE is a safe and feasible option for patients requiring left sided resection for diverticular disease based on the current available data. The literature demonstrates low rates of surgical site infection, mortality and reduced hospital length of stay.},
}

@article {pmid40134640,
year = {2025},
author = {Khan, A and Mushtaq, M and Movva, G and Sohal, A and Yang, J},
title = {Gastrointestinal disease in end-stage renal disease.},
journal = {World journal of nephrology},
volume = {14},
number = {1},
pages = {101917},
pmid = {40134640},
issn = {2220-6124},
abstract = {When kidney function declines to a point where it can no longer maintain life and requires renal replacement therapy (i.e. renal transplant or dialysis), it is called end-stage renal disease (ESRD). Patients with ESRD often experience a range of gastrointestinal (GI) symptoms, with prevalence rates reported as high as 77%-79%. These symptoms and pathologies arise from various factors, including electrolyte imbalance, fluid imbalance, toxin buildup, uremia, medications, dietary and lifestyle restrictions, and the effects of dialysis. GI diseases in patients with renal failure can be further categorized into upper GI, small bowel, and lower GI issues. Common conditions include gastroesophageal reflux disease, nausea and vomiting, dysmotility within the esophagus and stomach, upper GI bleeding, peptic ulcer bleeding, angioectasia, irritable bowel syndrome, mesenteric ischemia, angiodysplasia, diverticular disease, constipation, pancreatitis, and diseases associated with peritoneal dialysis peritonitis and peritoneal stenosis. This review assesses the existing literature on the different GI diseases among individuals with ESRD, shedding light on their pathophysiology and prevalence.},
}

@article {pmid40115966,
year = {2025},
author = {Cossais, F and Hörnke, MC and Schröder, K and Lucius, R and Böttner, M and Egberts, JH and Richter, F and Wedel, T},
title = {Phosphorylated alpha-synuclein distribution in the colonic enteric nervous system of patients with diverticular disease.},
journal = {IBRO neuroscience reports},
volume = {18},
number = {},
pages = {384-388},
pmid = {40115966},
issn = {2667-2421},
abstract = {BACKGROUND: Phosphorylated alpha-synuclein (P-aSyn) is a biomarker for Parkinson's disease (PD), with potential relevance in intestinal inflammatory disorders.

OBJECTIVES: This study examines the distribution of P-aSyn in colonic tissues of patients with diverticular disease (DD) compared to age-matched controls.

METHODS: P-aSyn distribution was analyzed in colon samples of 45 patients with diverticulitis (D-itis), 12 with diverticulosis (D-osis), and 30 controls via immunohistochemistry.

RESULTS: P-aSyn immunoreactivity was found along enteric neurons of the myenteric and submucosal plexus in 93.1 % of participants, with similar distribution across D-itis, D-osis, and controls. Elevated reactivity appeared in 16.7 % of D-osis, 19.6 % of D-itis, and 30.0 % of controls.

CONCLUSION: P-aSyn presence in colonic tissue did not significantly differ between DD patients and controls, suggesting that DD-related inflammation does not notably affect P-aSyn expression. Further research is warranted to explore aSyn roles within the enteric nervous system in intestinal inflammatory disorders and their relation with neurodegenerative diseases.},
}

@article {pmid40094139,
year = {2025},
author = {Lubanda, TJ and Schaeffer, HD},
title = {Re: "The Prevalence and Management Outcomes of Diverticular Disease in a Tertiary Facility in Ghana".},
journal = {Journal of the West African College of Surgeons},
volume = {15},
number = {2},
pages = {243},
pmid = {40094139},
issn = {2992-5827},
}

@article {pmid40091957,
year = {2025},
author = {O'Rorke, J and Butler, G and Moss, JA},
title = {Management of Acute Diverticulitis and Incidental Abdominal Aortic Aneurysm in a 67-Year-Old Male: A Case Report of Balancing Priorities in a High-Risk Patient.},
journal = {Cureus},
volume = {17},
number = {2},
pages = {e78987},
pmid = {40091957},
issn = {2168-8184},
abstract = {Diverticular disease and abdominal aortic aneurysms (AAAs) represent distinct but significant clinical entities often associated with advanced age. Diverticulitis, a common complication of diverticular disease, can result in perforation and systemic complications, while AAAs, frequently asymptomatic, carry substantial morbidity and mortality risks if undetected or untreated. Advances in imaging have improved the early identification of these conditions, yet the simultaneous management of both presents unique challenges requiring multidisciplinary coordination. A 67-year-old male with a history of ST-elevation myocardial infarction, hypertension, hyperlipidemia, and smoking presented with left lower quadrant abdominal pain and abnormal outpatient computed tomography (CT) findings. Imaging revealed Hinchey 1a diverticulitis with a microperforation and an incidental 6.5 cm saccular AAA. The patient received conservative treatment for diverticulitis with intravenous antibiotics and transitioned to oral antibiotics upon clinical improvement. Following resolution, the patient underwent successful endovascular aneurysm repair (EVAR) for the AAA, which was complicated by a type II endoleak identified postoperatively. Blood pressure management and hydration addressed acute kidney injury, and the patient recovered well with a multidisciplinary follow-up planned. This case underscores the importance of imaging in diagnosing coexisting conditions, particularly in high-risk populations. Management required balancing the risks of treating acute diverticulitis with the need for prompt intervention for a large, saccular AAA. The conservative approach to diverticulitis, followed by elective EVAR, reflects a patient-centered strategy consistent with current guidelines. Furthermore, it underscores the critical role of adhering to screening recommendations for high-risk populations, as timely detection of asymptomatic conditions like AAAs can prevent life-threatening complications.},
}

@article {pmid40091500,
year = {2025},
author = {Cameron, RA and Jones, MP and Eslick, GD and Talley, NJ},
title = {Colonic Diverticulosis and Uncomplicated Diverticulitis Are Associated With a Lower Not Higher Risk of Mortality When Confounding Factors Are Held Constant.},
journal = {Journal of gastroenterology and hepatology},
volume = {},
number = {},
pages = {},
doi = {10.1111/jgh.16928},
pmid = {40091500},
issn = {1440-1746},
support = {//National Health and Medical Research Council/ ; },
abstract = {BACKGROUND AND AIM: The association between colonic diverticulosis, diverticulitis, and mortality is controversial. This study evaluated the association between diverticular disease and mortality over a prolonged period in a GP cohort.

METHODS: GP records were sourced from the United Kingdom medical database (THIN). Diverticulosis and diverticulitis were identified via Read codes. The overall patient cohort (n = 1 274 260) included patients with colonic diverticula (n = 39 521 [3.1%], mean age 54) and no diverticula (control group) (n = 1 234 739 [96.9%], mean age 38). Poisson regression estimated relative rates, and durational time at risk and survival probability were calculated.

RESULTS: Colonic diverticula are associated with an increased mortality risk when compared with nondiverticular patients (OR = 1.89, 95% CI 1.84-1.94; p < 0.001). However, controlling for age, sex, and potential confounding variables yielded a decreased mortality risk overall for colonic diverticula patients (HR = 0.66, 95% 0.64-0.6; p < 0.001). When the diverticulitis cohort is separated into uncomplicated and complicated, increased mortality is observed in both uncomplicated diverticulitis (HR = 0.64, 95% CI 0.61-0.66; p < 0.001) and complicated diverticulitis (HR = 1.14, 95% CI 1.02-1.28; p = 0.024), but on controlling for confounding, there is a decreased risk of mortality for uncomplicated diverticulitis (HR = 0.65, 95% CI 0.63-0.66; p < 0.001) but almost two times increased mortality risk for complicated diverticulitis (HR = 1.18, 95% CI 1.05-1.32; p = 0.006).

CONCLUSIONS: In this large UK GP sample, controlling for age, sex, and comorbidities, patients with uncomplicated diverticula are associated with a lower mortality risk. However, complicated diverticulitis still carries two times the risk of mortality than those with no or uncomplicated colonic diverticula.},
}

@article {pmid40085006,
year = {2025},
author = {Ueland, TE and Younan, SA and Evans, PT and Sims, J and Shroder, MM and Hawkins, AT and Peek, R and Niu, X and Bastarache, L and Robinson, JR},
title = {Unmet social needs and diverticulitis: a phenotyping algorithm and cross-sectional analysis.},
journal = {Journal of the American Medical Informatics Association : JAMIA},
volume = {32},
number = {5},
pages = {866-875},
pmid = {40085006},
issn = {1527-974X},
support = {U24 OD023176/OD/NIH HHS/United States ; 5 U2C OD023196//Data and Research Center/ ; HHSN 263201600085U//Federally Qualified Health Centers/ ; UL1 TR002243/TR/NCATS NIH HHS/United States ; 1 OT2 OD026549//Office of the Director: Regional Medical Centers/ ; K23 DK118192/DK/NIDDK NIH HHS/United States ; //National Institute of Diabetes and Digestive and Kidney Disease/ ; 1 U24 OD023163//Participant Technology Systems Center/ ; K23DK118192/NH/NIH HHS/United States ; OT2 OD026555/OD/NIH HHS/United States ; /TR/NCATS NIH HHS/United States ; U24 OD023163/OD/NIH HHS/United States ; },
mesh = {Humans ; *Algorithms ; Cross-Sectional Studies ; Male ; Female ; Middle Aged ; Severity of Illness Index ; *Diverticulitis/diagnosis/classification ; Phenotype ; Aged ; Health Services Accessibility ; Food Insecurity ; Logistic Models ; Adult ; },
abstract = {OBJECTIVE: To validate a phenotyping algorithm for gradations of diverticular disease severity and investigate relationships between unmet social needs and disease severity.

MATERIALS AND METHODS: An algorithm was designed in the All of Us Research Program to identify diverticulosis, mild diverticulitis, and operative or recurrent diverticulitis requiring multiple inpatient admissions. This was validated in an independent institution and applied to a cohort in the All of Us Research Program. Distributions of individual-level social barriers were compared across quintiles of an area-level index through fold enrichment of the barrier in the fifth (most deprived) quintile relative to the first (least deprived) quintile. Social needs of food insecurity, housing instability, and care access were included in logistic regression to assess association with disease severity.

RESULTS: Across disease severity groups, the phenotyping algorithm had positive predictive values ranging from 0.87 to 0.97 and negative predictive values ranging from 0.97 to 0.99. Unmet social needs were variably distributed when comparing the most to the least deprived quintile of the area-level deprivation index (fold enrichment ranging from 0.53 to 15). Relative to a reference of diverticulosis, an unmet social need was associated with greater odds of operative or recurrent inpatient diverticulitis (OR [95% CI] 1.61 [1.19-2.17]).

DISCUSSION: Understanding the landscape of social barriers in disease-specific cohorts may facilitate a targeted approach when addressing these needs in clinical settings.

CONCLUSION: Using a validated phenotyping algorithm for diverticular disease severity, unmet social needs were found to be associated with greater severity of diverticulitis presentation.},
}

Humans
*Algorithms
Cross-Sectional Studies
Male
Female
Middle Aged
Severity of Illness Index
*Diverticulitis/diagnosis/classification
Phenotype
Aged
Health Services Accessibility
Food Insecurity
Logistic Models
Adult

@article {pmid40078388,
year = {2025},
author = {Tursi, A and Procaccianti, G and De Bastiani, R and Turroni, S and D'Amico, F and Allegretta, L and Antonino, N and Baldi, E and Casamassima, C and Casella, G and Ciuffi, M and De Bastiani, M and Lazzarotto, L and Licci, C and Mancuso, M and Penna, A and Pranzo, G and Sanna, G and Tosetti, C and Zamparella, M and Picchio, M},
title = {Micro-encapsulated and colonic-release sodium butyrate modulates gut microbiota and improves abdominal pain in patients with symptomatic uncomplicated diverticular disease.},
journal = {Frontiers in medicine},
volume = {12},
number = {},
pages = {1487892},
pmid = {40078388},
issn = {2296-858X},
abstract = {The role of gut microbiota (GM) in the pathogenesis of Symptomatic Uncomplicated Diverticular Disease (SUDD) remains controversial. Here, we assessed the efficacy of a butyrate formulation in modulating GM and abdominal pain in patients with SUDD. A retrospective study was conducted in patients with SUDD who were treated with a delayed- and colonic-release formulation of butyrate (two capsules bid, for a total dose of 400 mg butyrate) for 3 months. GM was profiled before (T0) and after 90 days of treatment (T2) using 16S rRNA amplicon sequencing. The primary endpoint was change in GM at T2; secondary endpoints were reduction in abdominal pain severity according to VAS (Visual Analog Scale, 0: absence; 10: maximum severity) at T1 (45 days) and T2, stool characteristics according to the Bristol stool form scale at T0, T1 and T2, and safety of treatment. Fifty-nine patients with SUDD (59.3% male; median age 65.5 years, interquartile range 55-71 years) completed treatment. The butyrate formulation increased GM diversity and resulted in several compositional changes that were closely related to baseline abdominal pain severity. Regarding secondary endpoints, abdominal pain decreased significantly over time, while the Bristol stool form scale did not. Mild adverse events were recorded in 3 (5.08%) patients. This study showed that a microencapsulated and colonic-release formulation of butyrate favorably modulates GM and reduces abdominal pain in patients with SUDD.},
}

@article {pmid40070644,
year = {2025},
author = {Flores, R and Calvo, PA and Antunes, C and Duarte, R and Lérias, G},
title = {Ruminococcus gnavus Bacteremia in a SARS-CoV-2 Patient With Diverticulosis.},
journal = {Cureus},
volume = {17},
number = {2},
pages = {e78784},
pmid = {40070644},
issn = {2168-8184},
abstract = {Ruminococcus gnavus is a constituent of the human intestinal microbiota, found in the commensal flora of healthy individuals. Changes in the intestinal microflora associated with chronic conditions and immunosuppression promote the bacterial translocation of R. gnavus. We present a case of bacteremia due to R. gnavus in an elderly man with multiple comorbidities, including diverticular disease and moderate SARS-CoV-2 infection requiring corticosteroid therapy. He had a prolonged hospital stay and multiple infectious complications. According to the literature review in databases such as PubMed (the last search was conducted in August 2023), a total of 17 cases were described. The reported cases had in common gastrointestinal symptoms such as gastrointestinal bleeding, diverticular disease, ulcerative colitis, cholecystitis, gastrointestinal fistula, or infection due to an orthopedic prosthesis. There was also a case in a patient with hemato-oncological disease, previously treated with a cycle of corticosteroids. It was considered that, alongside the history of diverticular disease, the immunosuppression secondary to the corticosteroid therapy for the SARS-CoV-2 infection may have contributed to the imbalance of the intestinal microbiome, leading to the occurrence of bacteremia due to this commensal agent.},
}

@article {pmid40037806,
year = {2025},
author = {Dalby, HR and Erichsen, R and Gotschalck, KA and Emmertsen, KJ},
title = {Colonic resection and stoma formation due to chronic diverticular disease: nationwide population-based cohort study.},
journal = {BJS open},
volume = {9},
number = {2},
pages = {},
pmid = {40037806},
issn = {2474-9842},
support = {NNF21OC0071125//The Novo Nordisk Foundation/ ; },
mesh = {Humans ; Male ; Female ; Denmark/epidemiology ; Aged ; Middle Aged ; *Elective Surgical Procedures/adverse effects ; *Colectomy/adverse effects ; Chronic Disease ; Incidence ; Diverticular Diseases/surgery/epidemiology ; Cohort Studies ; Aged, 80 and over ; Adult ; Registries ; Surgical Stomas/adverse effects/statistics & numerical data ; Proportional Hazards Models ; },
abstract = {BACKGROUND: Consensus on patient selection for elective colonic resection in patients with chronic diverticular disease is lacking. Early identification of patients who require surgery eventually enables timely elective resection, which could decrease the chronic diverticular disease burden. This register-based nationwide cohort study aimed to investigate the incidence of emergency and elective colonic resections or stoma formation in patients with chronic diverticular disease and explore predictors for surgery.

METHODS: The study included all patients with chronic diverticular disease in Denmark from 1996 to 2020, defined as patients with two or more hospital contacts due to diverticular disease. The incidence of surgery due to chronic diverticular disease was calculated as cumulative incidence proportions. Predictors for surgery were explored in a Cox proportional hazard model.

RESULTS: A total of 33 951 patients with chronic diverticular disease were included. The overall 5-year cumulative incidence proportion of surgery was 13.9% (elective surgery 9.8%, emergency surgery 4.2%). Patients with complicated chronic diverticular disease, including fistula, stenosis or perforation, had a three- to six-fold higher incidence of surgery overall than patients with uncomplicated chronic diverticular disease. The incidence of elective surgery decreased with age and co-morbidity and increased with the number of emergency admissions, even more pronounced if the emergency admissions accumulated within a shorter interval.

CONCLUSION: Patients with chronic diverticular disease should be considered for elective colonic resection if they have complicated disease or several hospital contacts as they are likely to undergo surgery eventually.},
}

Humans
Male
Female
Denmark/epidemiology
Aged
Middle Aged
*Elective Surgical Procedures/adverse effects
*Colectomy/adverse effects
Chronic Disease
Incidence
Diverticular Diseases/surgery/epidemiology
Cohort Studies
Aged, 80 and over
Adult
Registries
Surgical Stomas/adverse effects/statistics & numerical data
Proportional Hazards Models

@article {pmid40021082,
year = {2025},
author = {McKechnie, T and Heimann, L and Sharma, S and Staibano, P and Nanji, K and Garfinkle, R and Garoufalia, Z and Doumouras, A and Parpia, S and Bhandari, M and Eskicioglu, C},
title = {Patients with class III obesity are at elevated risk of postoperative morbidity after surgery for left-sided diverticular disease: a retrospective population-level study.},
journal = {Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract},
volume = {29},
number = {5},
pages = {102004},
doi = {10.1016/j.gassur.2025.102004},
pmid = {40021082},
issn = {1873-4626},
mesh = {Retrospective Studies ; *Postoperative Complications/epidemiology/etiology ; Risk Factors ; Body Mass Index ; *Obesity, Morbid/complications/diagnosis/epidemiology ; *Diverticulosis, Colonic/etiology/surgery ; *Colectomy/adverse effects/methods ; Humans ; Male ; Female ; Adult ; Middle Aged ; Aged ; Severity of Illness Index ; },
abstract = {BACKGROUND: Although obesity is a well-established risk factor for the development of diverticular disease, studies focusing on the effect of body mass index (BMI) on postoperative outcomes require updating. This population-level retrospective cohort study was designed to evaluate the effect of BMI on postoperative outcomes after operative intervention for left-sided diverticular disease.

METHODS: This was a population-based retrospective cohort study using the Healthcare Cost and Utilization Project National Inpatient Sample (NIS) (September 1, 2015 to December 31, 2019). The International Classification of Diseases, 10th Revision, Clinical Modification codes were used to identify a cohort of adult patients with a primary admission diagnosis of diverticulitis. Patients were stratified according to obesity status (ie, not obese: BMI of <30.0 kg/m[2]; class I obesity: BMI of 30.0-34.9 kg/m[2]; class II obesity: BMI of 35.0-39.9 kg/m[2]; class III obesity: BMI of >40.0 kg/m[2]). The primary outcome was overall in-hospital postoperative morbidity. The multivariate regression models were fit.

RESULTS: There were 33,029 patients identified in the NIS who underwent left-sided colonic resection for diverticular disease. There were 27,212 patients who were not obese, 2209 patients with class I obesity, 1710 patients with class II obesity, and 1898 patients with class III obesity. Patients with class III obesity (ie, a BMI of >40.0 kg/m[2]) had 72.7% higher odds (95% CI, 1.54-1.94) of experiencing in-hospital postoperative morbidity than patients with a BMI of <30.0 kg/m[2]. Patients with class III obesity had 26.9% higher odds (95% CI, 0.98-1.65) of experiencing in-hospital postoperative infection, 54.6% higher odds (95% CI, 1.35-1.77) of experiencing in-hospital postoperative gastrointestinal complications, and 70.9% higher odds (95% CI, 1.48-1.97) of experiencing in-hospital postoperative genitourinary complications than those with a BMI of <30.0 kg/m[2].

CONCLUSION: Patients with class III obesity undergoing operative intervention for colonic diverticular disease are at increased risk of short-term postoperative morbidity compared with those with a BMI of <30.0 kg/m[2].},
}

Retrospective Studies
*Postoperative Complications/epidemiology/etiology
Risk Factors
Body Mass Index
*Obesity, Morbid/complications/diagnosis/epidemiology
*Diverticulosis, Colonic/etiology/surgery
*Colectomy/adverse effects/methods
Humans
Male
Female
Adult
Middle Aged
Aged
Severity of Illness Index

@article {pmid40012838,
year = {2025},
author = {Carabotti, M and Marasco, G and Radaelli, F and Barbara, G and Cuomo, R and Annibale, B},
title = {Look inside the management of colonic diverticular rebleeding: a systematic review.},
journal = {Therapeutic advances in gastroenterology},
volume = {18},
number = {},
pages = {17562848251321695},
pmid = {40012838},
issn = {1756-283X},
abstract = {BACKGROUND: Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding in adults and carries a significant risk of recurrence. However, there are many uncertainties regarding the management of the prevention of diverticular rebleeding.

OBJECTIVES: To review the current evidence on the potential role of lifestyle, pharmacological and endoscopic treatments and to discuss the unmet needs in the prevention of colonic diverticular rebleeding.

DESIGN: A systematic review.

DATA SOURCES AND METHODS: Based on the identified Patients-Interventions-Comparators-Outcomes questions, a detailed and comprehensive literature search was conducted, from inception to 12 January 2024, without language restriction, according to the modified Preferred Reporting Items for Systematic review and Meta-Analyses reporting guidelines.

RESULTS: We did not find any dietary or lifestyle interventions (fibre intake, smoking, physical activity, alcohol consumption, BMI) to prevent colonic diverticular rebleeding. We also did not find any interventional studies of specific pharmacological treatments (such as rifaximin, mesalazine or probiotics) to prevent diverticular rebleeding. Data comparing endoscopic and conservative approaches used during the index episode come from observational studies and show conflicting results. Finally, there is a paucity of data regarding the timing of resumption of antiplatelet and anticoagulant therapy after an episode of colonic diverticular bleeding, and this remains to be determined.

CONCLUSION: This review highlights the paucity of data on the possible role of lifestyle, pharmacological and endoscopic treatments in the prevention of colonic diverticular rebleeding and advocates future studies aimed at finding effective therapeutic strategies.},
}

@article {pmid40007587,
year = {2025},
author = {Papagrigoriadis, S and Charalampopoulos, A},
title = {Surgery for diverticular peritonitis.},
journal = {Frontiers in medicine},
volume = {12},
number = {},
pages = {1501734},
pmid = {40007587},
issn = {2296-858X},
abstract = {Some patients with acute diverticulitis will present with colonic perforation and peritonitis. This paper is a review of the surgical management of diverticular peritonitis Hinchey III and Hinchey IV. The significance of prompt management of sepsis is discussed. The surgical options for Hinchey III and Hinchey IV peritonitis are discussed with presentation of the supporting literature. In Hinchey III peritonitis Laparoscopic Peritoneal Lavage has emerged as an alternative to laparotomy-colectomy. The classic Hartmann's operation has no advantage of survival and results frequently in permanent stoma. Recent published evidence supports on table colonic lavage and the performance of primary anastomosis unless the patient is critically ill.},
}

@article {pmid39997529,
year = {2025},
author = {Hashi, R and Thamer, R and Hassan, A and Canna, K and Ahmed, M and Hassan, MT and Badi, S and Ahmed, MH},
title = {A Contemporary Multifaceted Insight into the Association Between Diabetes Mellitus and Diverticular Disease: An Update About Geriatric Syndrome.},
journal = {Geriatrics (Basel, Switzerland)},
volume = {10},
number = {1},
pages = {},
pmid = {39997529},
issn = {2308-3417},
abstract = {Introduction: Diverticular disease, once considered a rare geriatric gastrointestinal condition, has now become a prevalent disorder associated with increased morbidity and healthcare costs. The spectrum of complications from diverticular disease ranges from incidental findings to more serious issues such as bleeding and diverticulitis. Symptomatic diverticular disease represents a significant economic burden in the western world. Diabetes mellitus is a major global health issue. As global aging accelerates, geriatric syndromes such as diabetes mellitus (DM) and diverticular disease (DD) are becoming increasingly prevalent. Understanding their interplay is critical, particularly within the geriatric population. Both conditions are linked to lifestyle, dietary habits, and changes in gut physiology. Additionally, age-related alterations in the gut microbiome and immune system make this association more complex, contributing to morbidity and healthcare burdens in older adults. The primary aim of this review is to provide an update on the association between diabetes mellitus and diverticular disease. Methods: This narrative review explores the association between diabetes mellitus and diverticular disease. Relevant articles were identified by searching major databases. Results: Risk factors for diverticular disease include insulin resistance, diabetes mellitus, smoking, non-alcoholic fatty liver disease, lack of physical activity, a low-fibre diet, and a high-carbohydrate diet. These risk factors are also associated with the development of diabetes mellitus. Major population studies indicate that diabetes can either increase the risk of diverticular disease or have a neutral impact. A complication of diabetes mellitus includes impaired intestinal peristalsis and enteric nervous system dysfunction, which can ultimately lead to the formation of intestinal diverticula. High-calorie foods low in fibre are a staple in the diets of many type 2 diabetes mellitus patients, contributing to gut dysbiosis. A detrimental consequence of dysbiosis is a breach in the protective intestinal barrier, which promotes the development of diverticulosis. Conclusions: Diabetes mellitus may be associated with diverticular disease, and the risk factors that contribute to diabetes mellitus can also be linked to diverticular disease. Further studies are needed to explore the complex relationship between diabetes mellitus and diverticular disease.},
}

@article {pmid39996222,
year = {2025},
author = {Miranda Thais, R and Sarofim, M and Gilmore, A},
title = {Complicated Sigmoid Diverticulitis Mimicking Pelvic Pain in a Patient With Giant Uterine Fibroids: A Case Report.},
journal = {Cureus},
volume = {17},
number = {1},
pages = {e77979},
pmid = {39996222},
issn = {2168-8184},
abstract = {This report describes the case of a woman in her late forties with a history of large uterine fibroids who presented to the Emergency Department with colicky suprapubic pain and urinary symptoms. Initial computed tomography (CT) showed uncomplicated acute diverticulitis but despite antibiotic treatment, her condition worsened, and a follow-up CT revealed sigmoid perforation, requiring high anterior resection and subtotal hysterectomy. The case highlights how large fibroids exert external pressure on the colon, impairing motility and increasing the risk of diverticula formation. Alterations in the gut microbiome may contribute to colonic mucosal inflammation, commonly seen in diverticular disease. Patients with uterine fibroids have altered microbiome composition, which could further increase the risk of diverticular disease. These findings provide a pathway for future research into the influence of uterine fibroids on the pathophysiology of diverticular disease.},
}

@article {pmid39976023,
year = {2025},
author = {Zhou, J and Xu, Y and Wang, H and Wang, K and Chen, C},
title = {Exploring the Diet-diverticular Disease Link: Insights from a Comprehensive Mendelian Randomization Study.},
journal = {Current medicinal chemistry},
volume = {},
number = {},
pages = {},
doi = {10.2174/0109298673342480250203111209},
pmid = {39976023},
issn = {1875-533X},
abstract = {BACKGROUND: The interplay between dietary habits and the development of Diverticular Disease (DD) has long been a subject of vibrant debate.

OBJECTIVE: Utilizing Mendelian Randomization (MR), this study aims to meticulously examine the causal dynamics at play.

METHODS: The foundation for the Genome-Wide Association Studies (GWAS) on DD was established using a dataset from the FinnGen consortium, encompassing 33,619 patients and 329,381 control participants. Data on 18 dietary habits and DD for the validation cohort were procured from the UK Biobank. An MR analysis was executed to delve into the causal relationship between dietary habits and DD, adhering to a rigorous Bonferroni correction threshold of 3.00E-03. Our main analysis method was the Inverse Variance Weighted (IVW) approach. To improve the accuracy and reliability of our study, we also conducted heterogeneity analysis, tests for horizontal pleiotropy, outlier identification, and "leave-one-out" sensitivity analysis.

RESULTS: Our analysis unearthed a potential causal association between the consumption of dried fruits and a lower risk of developing DD (IVW: odds ratio (OR) 0.372, 95% confidence interval (CI) 0.272 - 0.509, p = 5.79E-10), a finding that was corroborated in the validation cohort (IVW: OR 0.975, 95% CI 0.961 - 0.990, p = 1.04E-03). Conversely, our results do not substantiate a causal link between the consumption of alcohol, dietary fiber, and red meat and the risk of DD.

CONCLUSION: Our detailed MR analyses show that eating dried fruit lowers the risk of DD, providing strong support for prevention and treatment approaches for DD.},
}

@article {pmid39974228,
year = {2025},
author = {Mithany, RH and Shaikh, A and Murali, S and Rafique, A and Bebawy, PS and Nair, PG and Ramadan, W and Abdelglil, M and Gupta, A and Sayed, MA and Ismaiel, M},
title = {A Review of the Current Trends and Future Perspectives of Robots in Colorectal Surgery: What Have We Got Ourselves Into?.},
journal = {Cureus},
volume = {17},
number = {1},
pages = {e77690},
pmid = {39974228},
issn = {2168-8184},
abstract = {Robotic colorectal surgery represents a significant advancement in the management of complex colorectal conditions, offering enhanced precision, safety, and improved patient outcomes. It is widely utilised for colorectal cancer, inflammatory bowel disease, diverticular disease, and rectal prolapse, with key benefits such as 3D visualisation, superior dexterity, and precise navigation in confined spaces. These advantages contribute to lower conversion rates to open surgery, faster recovery, reduced pain, and shorter hospital stays. This narrative review analysed recent peer-reviewed literature, focusing on technological advancements, clinical outcomes, and emerging challenges in robotic colorectal surgery. Findings highlight improved oncological precision, faster recovery, and fewer complications, driven by innovations like AI-guided decision-making and advanced robotic platforms. However, issues such as prolonged operative times, high costs, and steep learning curves remain. Future efforts should prioritise integrating AI, enhancing surgeon training, and addressing cost barriers to maximise the potential of robotic colorectal surgery in improving patient care.},
}

@article {pmid39944930,
year = {2025},
author = {Liu, D and Cao, M and Wu, S and Jiang, Y and Cao, W and Lin, T and Li, F and Sha, F and Yang, Z and Tang, J},
title = {Modifiable factors for irritable bowel syndrome: evidence from Mendelian randomisation approach.},
journal = {eGastroenterology},
volume = {3},
number = {1},
pages = {e100126},
pmid = {39944930},
issn = {2976-7296},
abstract = {BACKGROUND: The potential modifiable factors influencing irritable bowel syndrome (IBS) have not been thoroughly documented. We aimed to systematically investigate the modifiable factors associated with IBS, while accounting for the impact of unobserved confounders and coexisting disorders.

METHODS: Genetic correlation and Mendelian randomisation (MR) analyses were integrated to identify potential modifiable factors and coexisting disorders linked to IBS. Subsequently, multiresponse MR (MR[2]) was employed to further examine these associations. Summary-level genome-wide association data were used. Modifiable factors and coexisting disorders (ie, gastrointestinal and psychiatric disorders) were identified based on evidence from cohort studies and meta-analysis. In all analyses, IBS was the primary outcome, while in the MR[2] analysis, coexisting disorders were also treated as outcomes alongside IBS.

RESULTS: Most identified modifiable factors and coexisting disorders exhibited genetic correlations with IBS. MR analyses revealed strong causation between IBS and multisite chronic pain (OR=2.20, 95% CI 1.82 to 2.66), gastro-oesophageal reflux disease (OR=1.31, 95% CI 1.23 to 1.39), well-being spectrum (OR=0.17, 95% CI 0.13 to 0.21), life satisfaction (OR=0.31, 95% CI 0.25 to 0.38), positive affect (OR=0.30, 95% CI 0.24 to 0.37), neuroticism score (OR=1.20, 95% CI 1.16 to 1.25) and depression (OR=1.50, 95% CI 1.37 to 1.66). Additionally, smoking, alcohol frequency, college or university degree, intelligence, childhood maltreatment, frailty index, diverticular disease of the intestine and schizophrenia were suggestively associated with IBS. Robust associations were found between multisite chronic pain and both IBS and coexisting disorders.

CONCLUSIONS: Our study identified a comprehensive array of potential modifiable factors and coexisting disorders associated with IBS, supported by genetic evidence, including genetic correlation and multiple MR analyses. The presence of multisite chronic pain may offer a promising avenue for the concurrent prevention of IBS and its coexisting disorders.},
}

@article {pmid39932214,
year = {2025},
author = {Tessler, RA and Vaughan Sarrazin, MS and Gao, Y and Jacobs, MA and Jacobs, CA and Hausmann, LRM and Hall, DE},
title = {Area Deprivation, Fragmented Care, and Colectomy Case Acuity in the Veterans Health Administration.},
journal = {Diseases of the colon and rectum},
volume = {68},
number = {5},
pages = {627-636},
doi = {10.1097/DCR.0000000000003659},
pmid = {39932214},
issn = {1530-0358},
mesh = {Humans ; *Colectomy/statistics & numerical data ; United States/epidemiology ; Male ; Aged ; Retrospective Studies ; Female ; United States Department of Veterans Affairs/statistics & numerical data ; Veterans/statistics & numerical data ; },
abstract = {BACKGROUND: Colectomy for benign or malignant disease may be elective, urgent, or emergent. Data suggest successively worse outcomes for nonelective colectomy. Limited data exist regarding the contribution of high area deprivation index and care fragmentation to nonelective colectomy.

OBJECTIVE: Determine the association between area deprivation and nonelective colectomy in the Veterans Health Administration and assess whether accounting for differences in care fragmentation alters the association across indications and for benign and malignant conditions separately.

DESIGN: Retrospective cohort with multivariable multinomial logit models to evaluate associations between high-deprivation care fragmentation and the adjusted odds of nonelective colectomy. We calculated total, direct, and indirect effects to assess whether the association varied by levels of care fragmentation.

SETTING: Veterans receiving care in the private sector and Veterans Health Administration.

PATIENTS: Veterans aged 65 years or older undergoing colectomy between 2013 and 2019 were included.

MAIN OUTCOME MEASURES: Colectomy case acuity.

RESULTS: We identified 6538 colectomy patients, of whom 3006 (46.0%) were identified for malignancy. The odds of emergent colectomy were higher for patients in high-deprivation areas when the indication was for benign pathology (adjusted OR 1.51; 95% CI, 1.15-2.00). For malignant indications, there was no association between high deprivation and nonelective colectomy. More fragmented care was associated with higher odds of urgent and emergent colectomy for both benign and malignant indications, but the association between deprivation and nonelective colectomy did not vary by care fragmentation.

LIMITATIONS: Inherent to large administrative retrospective databases.

CONCLUSIONS: Veterans living in high-deprivation areas are at higher risk for emergent colectomy for benign conditions. Care fragmentation is also associated with a higher risk of emergent colectomy across indications. Efforts to reduce care fragmentation and promote early detection of IBD and diverticular disease in high-deprivation neighborhoods may lower the risk for nonelective colectomy in veterans. See Video Abstract .

ANTECEDENTES:La colectomía por enfermedad benigna o maligna puede ser electiva, urgente o de emergencia. Los datos sugieren resultados cada vez peores para la colectomía no electiva. Existen pocos datos sobre la contribución del alto índice de privación de área y la fragmentación de la atención a la colectomía no electiva.OBJETIVO:Determinar la asociación entre la privación de área y la colectomía no electiva en la Administración de Salud de Veteranos (VHA) y evaluar si tener en cuenta las diferencias en la fragmentación de la atención altera la asociación entre las indicaciones y para las condiciones benignas y malignas por separado.DISEÑO:Cohorte retrospectiva con modelos logit multinomiales multivariables para evaluar las asociaciones entre la alta fragmentación de la atención por privación y las probabilidades ajustadas de colectomía no electiva. Calculamos los efectos totales, directos e indirectos para evaluar si la asociación variaba según los niveles de fragmentación de la atención.ESCENARIO:Veteranos que reciben atención en el sector privado y la VHA.PACIENTES:Veteranos ≥ 65 años sometidos a colectomía entre 2013 y 2019.

RESULTADO PRINCIPAL/MEDIDAS: Gravedad de los casos de colectomíaRESULTADOS:Identificamos 6538 pacientes de colectomía, de los cuales 3006 (46,0%) fueron por neoplasia maligna. Las probabilidades de colectomía de emergencia fueron mayores para los pacientes en áreas de alta privación cuando la indicación fue por patología benigna (aOR 1,51 IC del 95% 1,15, 2,00). Para las indicaciones malignas, no hubo asociación entre la alta privación y la colectomía no electiva. La atención más fragmentada se asoció con mayores probabilidades de colectomía urgente y de emergencia tanto para indicaciones benignas como malignas, pero la asociación entre la privación y la colectomía no electiva no varió según la fragmentación de la atención.LIMITACIONES:Inherentes a las grandes bases de datos administrativas retrospectivas.CONCLUSIONES:Los veteranos que viven en zonas de alta pobreza tienen un mayor riesgo de colectomía de urgencia por afecciones benignas. La fragmentación de la atención también se asocia con un mayor riesgo de colectomía de urgencia en todas las indicaciones. Los esfuerzos para reducir la fragmentación de la atención y promover la detección temprana de la enfermedad inflamatoria intestinal y la enfermedad diverticular en barrios de alta pobreza pueden reducir el riesgo de colectomía no electiva en los veteranos. (Traducción-Dr Yolanda Colorado).},
}

Humans
*Colectomy/statistics & numerical data
United States/epidemiology
Male
Aged
Retrospective Studies
Female
United States Department of Veterans Affairs/statistics & numerical data
Veterans/statistics & numerical data

@article {pmid39930644,
year = {2025},
author = {Saeed, U and Saunes, T and Sjo, OH and Schultz, J},
title = {Giant Colonic Diverticulum: Case report of a rare complication of a common disease.},
journal = {International journal of surgery case reports},
volume = {127},
number = {},
pages = {110909},
pmid = {39930644},
issn = {2210-2612},
abstract = {INTRODUCTION AND IMPORTANCE: Giant Colonic Diverticulum (GCD) is a rare but potentially life-threatening complication of diverticular disease, defined as a diverticulum larger than 4 cm, most commonly arising in the sigmoid colon. Its rarity could lead to diagnostic delays and mismanagement.

CASE PRESENTATION: A 64-year-old Caucasian female presented with persistent abdominal pain and abdominal swelling. Examination revealed a palpable mass in the left flank. A computed tomography (CT) scan demonstrated an 11x10x14 cm air-filled cavity adjacent to the sigmoid colon, initially misdiagnosed as contained perforated diverticulitis. Following a literature review, the diagnosis of GCD was considered. Definitive treatment involved a segmental sigmoid colectomy with en-bloc resection of the diverticulum. The postoperative course was uneventful, and the patient was discharged on postoperative day four with complete symptom resolution.

CLINICAL DISCUSSION: The presentation of GCD can mimic common complications of diverticular disease, making diagnosis challenging. CT imaging is critical, typically showing a large air-filled cavity connected to the colon. Surgical resection is the treatment of choice to prevent serious complications such as perforation, abscess, volvulus, or malignancy. In this case, en-bloc resection proved effective, highlighting the importance of prompt surgical management.

CONCLUSION: GCD is a rare and under-recognized clinical entity. Increased awareness is essential to ensure timely diagnosis and treatment. This case underscores the importance of integrating imaging findings, clinical judgment, and surgical intervention for optimal outcomes and emphasizes the need for further case documentation to aid in management strategies.},
}

@article {pmid39881898,
year = {2024},
author = {Perez-Carrillo, N and O'Farril-Anzures, R and Contreras Galván, N and Rojas-Granados, A and Angeles-Castellanos, M},
title = {Triple Colonic Fistula Due to Complicated Diverticular Disease and Its Surgical Management.},
journal = {Cureus},
volume = {16},
number = {12},
pages = {e76623},
pmid = {39881898},
issn = {2168-8184},
abstract = {Diverticular colon disease is the most common cause of colovesical fistulas, a rare and complex entity in their diagnosis and treatment. This report details the case of a 56-year-old patient who had presented with pneumaturia and gas in the vagina for six years and exudate in the abdominal wall in a midline wound. Given the suspicion, the diagnosis of the triple colonic fistula was confirmed by imaging studies: enteroatmospheric, colovesical, and colotubal, which were managed surgically.},
}

@article {pmid39845636,
year = {2024},
author = {Fahrner, R and Dohner, E and Kierdorf, FJ and Canal, C and Neuhaus, V},
title = {Retrospective registry-based nationwide analysis of the COVID-19 lockdown effect on the volume of general and visceral non-malignant surgical procedures.},
journal = {Surgery in practice and science},
volume = {17},
number = {},
pages = {100241},
pmid = {39845636},
issn = {2666-2620},
abstract = {INTRODUCTION: Coronavirus disease 2019 (COVID-19) is an acute virus infection, which was declared a pandemic by the World Health Organization. The Swiss government decreed a public lockdown to reduce and restrict further infections. The aim of this investigation was to analyze the impact of the first COVID-19 lockdown on the performance of general and visceral surgery procedures.

MATERIALS AND METHODS: A retrospective study was performed on the basis of the surgical registry of the working group for quality assurance in surgery ("Arbeitsgemeinschaft für Qualitätssicherung in der Chirurgie" or AQC). All patients with specific surgical diagnoses (complicated gastric or duodenal ulcer, acute appendicitis, hernia, diverticular disease, gallstone disease, pilonidal sinus, cutaneous and perianal abscess) were analyzed during 2019 and the corresponding lockdown period of March 14 through April 26, 2020. Data regarding patients' characteristics, diagnoses, and treatments were analyzed.

RESULTS: In total, 3,330 patients were analyzed, with 2,203 patients treated in 2019 and 1,127 patients treated in 2020. There was a reduction in the number of all investigated diagnoses during the pandemic period, with statistically significant differences in acute appendicitis, hernia, diverticular disease, gallstone disease, pilonidal sinus (all p < 0.001), and cutaneous abscess (p = 0.01). The proportion of complicated appendicitis (p = 0.02), complicated hernia (p < 0.001), and complicated gallstone disease (choledocholithiasis p = 0.01; inflammation, p = 0.001) was significantly higher during the lockdown period. The surgical urgency rate in all patients was higher during the lockdown period compared to the control period (p < 0.001).

CONCLUSIONS: The socioeconomic lockdown significantly impacted the number of general and visceral surgery procedures in Switzerland. The reasons for the reduction are multifactorial.},
}

@article {pmid39828300,
year = {2025},
author = {Ong Ming San, E and Ali, M and Sprakes, MB and Burr, NE},
title = {Giant sigmoid diverticulum.},
journal = {BMJ case reports},
volume = {18},
number = {1},
pages = {},
doi = {10.1136/bcr-2023-258689},
pmid = {39828300},
issn = {1757-790X},
mesh = {Humans ; Male ; *Diverticulum, Colon/surgery/diagnostic imaging/complications ; Tomography, X-Ray Computed ; Colon, Sigmoid/pathology/surgery/diagnostic imaging ; Sigmoid Diseases/surgery/diagnostic imaging/diagnosis ; Aged ; },
abstract = {Giant colonic diverticulum is an uncommon presentation of colonic diverticular disease. It is characterised by the presence of a diverticulum exceeding 4 cm in size, with approximately 90% of the cases involving the sigmoid colon. Typically, diagnosis relies on CT of the abdomen and pelvis (CTAP). The preferred treatment approach is sigmoid resection with a primary colonic anastomosis. However, in complicated or emergency cases, proctosigmoidectomy with end colostomy (Hartmann's procedure) is often considered the safest surgical option.We present an atypical case of a symptomatic patient with a giant sigmoid diverticulum that had increased in size and symptoms over several years. Initial diagnosis by CTAP revealed an incidental 6 cm sigmoid diverticulum. Over approximately 6 years, the diverticulum enlarged substantially, reaching 20 cm in size. This caused compression of the stomach and splinting of the left hemidiaphragm, resulting in nutritional failure. He was admitted with a plan to optimise for curative surgery; however complications such as nutritional failure and frailty developed, leading to a decision for palliative care.},
}

Humans
Male
*Diverticulum, Colon/surgery/diagnostic imaging/complications
Tomography, X-Ray Computed
Colon, Sigmoid/pathology/surgery/diagnostic imaging
Sigmoid Diseases/surgery/diagnostic imaging/diagnosis
Aged

@article {pmid39824785,
year = {2025},
author = {Winter, J and Clark, G and Steele, R and Thornton, M},
title = {Post-colonoscopy cancer rates in Scotland from 2012 to 2018: A population-based cohort study.},
journal = {Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland},
volume = {27},
number = {1},
pages = {e17298},
doi = {10.1111/codi.17298},
pmid = {39824785},
issn = {1463-1318},
mesh = {Humans ; Scotland/epidemiology ; Female ; *Colonoscopy/statistics & numerical data ; Male ; Middle Aged ; *Colorectal Neoplasms/diagnosis/epidemiology ; Aged ; *Early Detection of Cancer/statistics & numerical data/methods ; Cohort Studies ; Incidence ; Referral and Consultation/statistics & numerical data ; State Medicine/statistics & numerical data ; },
abstract = {AIM: The aim of this work was to quantify post-colonoscopy colorectal cancer (PCCRC) rates in National Health Service (NHS) Scotland using World Endoscopy Association guidelines, compare incidence between health boards and referral streams and explore comparisons in results with published data from other healthcare systems.

METHOD: This is a population-based cohort study using NHS Scotland data between 2012 and 2018. All people undergoing colonoscopy between 2012 and 2018 and subsequently diagnosed as having bowel cancer up to 3 years after their investigation were included. The main outcome measures are national trends in the PCCRC rate at 3 years (PCCRC-3yr). with comparison between bowel screening and non-screening referral routes, board of referral and analysis of factors associated with occurrence.

RESULTS: The overall unadjusted PCCRC-3yr was 7.9% (7.4%-8.3%). There was no change in the annual rate over the 7-year study period. The PCCRC rate was lower for the Scottish Bowel Cancer Screening Programme (6.7% vs. 8.3%), but compared unfavourably with rates reported by the NHS England Bowel Cancer Screening Programme from an earlier time period. There was wide variation in rates between health boards of similar population size. Rates were higher in women, with increasing age and in patients with a history of inflammatory bowel disease or diverticular disease.

CONCLUSION: Despite advances in technology, there has been no improvement in the PCCRC rate in Scotland between 2012 and 2018. Rates in bowel screening colonoscopy are better than in nonscreening colonoscopy but compare unfavourably with NHS England, possibly as a result of less robust endoscopist selection and training. Quality improvement is required in colonoscopy in order to improve patient outcomes nationally, and to allow equitable access to higher-quality colonoscopy in different regions of the country.},
}

Humans
Scotland/epidemiology
Female
*Colonoscopy/statistics & numerical data
Male
Middle Aged
*Colorectal Neoplasms/diagnosis/epidemiology
Aged
*Early Detection of Cancer/statistics & numerical data/methods
Cohort Studies
Incidence
Referral and Consultation/statistics & numerical data
State Medicine/statistics & numerical data

@article {pmid39822402,
year = {2024},
author = {Baker, JT and Cury, R and Hernandez-Suarez, DF},
title = {Myocarditis as a Possible Underlying Cause for Mid-Ventricular Takotsubo Cardiomyopathy: A Case Report.},
journal = {Cureus},
volume = {16},
number = {12},
pages = {e75813},
pmid = {39822402},
issn = {2168-8184},
abstract = {Our case report characterizes a rare presentation of mid-ventricular Takotsubo cardiomyopathy (TTC) in a patient with suspected myocarditis as an underlying cause. Mid-ventricular TTC is a rare variant of TTC presenting with overlapping symptoms and physical exam findings of acute coronary syndrome, which often leads to misdiagnosis as myocardial infarction. Our case is of a 77-year-old female patient with a history of hyperlipidemia, right breast ductal carcinoma in situ, and diverticular disease who presented to the emergency department for evaluation of chest pain radiating to the jaw with associated nausea and vomiting. She had a similar event eight months earlier and was diagnosed with ischemia with non-obstructive coronary arteries (INOCA) based on cardiac catheterization findings. Family history was notable for myocardial infarction in the patient's father and paternal grandfather. At presentation, the patient had elevated blood pressure, elevated troponins (initially 1058 ng/L with a repeat level of 11,421 ng/L), and electrocardiogram (ECG) findings of sinus bradycardia without ischemic changes. Cardiac MRI (CMR) revealed sub-epicardial delayed enhancement suggestive of possible myocarditis and diffuse hypokinesis involving the inferolateral left ventricular wall, sparing the basal and apical segments. Left ventricular function was mildly decreased (ejection fraction of 49%) and improved prior to discharge with ejection fraction (55-60%). There were no wall motion abnormalities or significant valve disease. This case presentation exemplifies a rare manifestation of mid-ventricular TTC that occurred in the setting of underlying myocarditis. Given the patient's history, elevated troponins, and CMR results suggestive of myocarditis, we hypothesize that underlying myocarditis may have incited the development of mid-ventricular TTC. The absence of identifiable triggers in conjunction with the inferolateral ventricular wall hypokinesis and late gadolinium enhancement on CMR supports our hypothesis. The variability in clinical presentations between the present case and other reported cases of mid-ventricular TTC emphasizes the need for a deeper understanding of this condition, its triggers, and the associated clinical features to reduce the risk of future misdiagnoses. This case report highlights the significance of thorough imaging assessments for patients presenting with INOCA. Further investigations are warranted to determine underlying causes for hemodynamic instability and unique aspects of the mid-ventricular manifestation of TTC, with an emphasis on the potential association of myocarditis as an inciting factor.},
}

@article {pmid39821452,
year = {2025},
author = {Kolbe, EW and Buciunas, M and Krieg, S and Loosen, SH and Roderburg, C and Krieg, A and Kostev, K},
title = {Minimally invasive versus open surgery for colonic diverticular disease: a nationwide analysis of German hospital data.},
journal = {Techniques in coloproctology},
volume = {29},
number = {1},
pages = {46},
pmid = {39821452},
issn = {1128-045X},
mesh = {Humans ; Male ; Female ; Germany/epidemiology ; Middle Aged ; Aged ; *Length of Stay/statistics & numerical data ; *Hospital Mortality ; *Postoperative Complications/epidemiology/etiology ; Laparoscopy/statistics & numerical data/methods/adverse effects ; Adult ; Robotic Surgical Procedures/statistics & numerical data/methods/adverse effects ; Treatment Outcome ; Diverticulitis, Colonic/surgery ; Diverticulum, Colon/surgery ; Aged, 80 and over ; Intestinal Perforation/surgery/etiology ; Minimally Invasive Surgical Procedures/methods/statistics & numerical data/adverse effects ; Retrospective Studies ; Colectomy/methods/adverse effects/statistics & numerical data ; },
abstract = {BACKGROUND: This study aims to evaluate the current rates and outcomes of minimally invasive versus open surgery for colonic diverticular disease in Germany, using a nationwide dataset.

METHODS: We analyzed data from 36 hospitals, encompassing approximately 1.25 million hospitalizations from 1 January 2019 to 31 December 2023. Patients aged 18 years and older with colonic diverticular disease (International Classification of Diseases, Tenth Revision (ICD-10): K57.2 and K57.3) who underwent surgical treatment were included. Surgeries were classified as open or minimally invasive (laparoscopic or robotic). Outcomes such as in-hospital mortality, complications, and length of stay were assessed using multivariable logistic and linear regression models.

RESULTS: Out of 1670 patients who underwent surgery for colonic diverticular disease, 63.2% had perforation and abscess. The rate of minimally invasive surgery increased from 34.6% in 2019 to 52.9% in 2023 for complicated cases and from 67.8% to 86.2% for uncomplicated cases. Open surgery was associated with higher in-hospital mortality (odds ratio (OR): 7.41; 95% CI: 2.86-19.21) and complications compared with minimally invasive surgery. The length of hospital stay was significantly longer for open surgery patients, with an increase of 4.6 days for those with perforation and abscess and 5.0 days for those without.

CONCLUSIONS: Minimally invasive surgery for colonic diverticular disease is increasingly preferred in Germany, especially for uncomplicated cases. However, open surgery remains common for complicated cases, but is associated with higher mortality, more complications, and longer hospital stays.},
}

Humans
Male
Female
Germany/epidemiology
Middle Aged
Aged
*Length of Stay/statistics & numerical data
*Hospital Mortality
*Postoperative Complications/epidemiology/etiology
Laparoscopy/statistics & numerical data/methods/adverse effects
Adult
Robotic Surgical Procedures/statistics & numerical data/methods/adverse effects
Treatment Outcome
Diverticulitis, Colonic/surgery
Diverticulum, Colon/surgery
Aged, 80 and over
Intestinal Perforation/surgery/etiology
Minimally Invasive Surgical Procedures/methods/statistics & numerical data/adverse effects
Retrospective Studies
Colectomy/methods/adverse effects/statistics & numerical data

@article {pmid39814952,
year = {2025},
author = {Mari, FS and Chiarini, L and Trampetti, L and Savina, C and Cosmi, F and Cicolani, A and Gasparrini, M and Brescia, A},
title = {Preservation of inferior mesenteric artery reduces short- and long-term defecatory dysfunction after laparoscopic colorectal resection for diverticular disease: An RCT.},
journal = {Surgical endoscopy},
volume = {39},
number = {3},
pages = {1761-1769},
pmid = {39814952},
issn = {1432-2218},
mesh = {Humans ; *Mesenteric Artery, Inferior/surgery ; Female ; Male ; *Laparoscopy/methods/adverse effects ; Middle Aged ; Aged ; Prospective Studies ; *Quality of Life ; Postoperative Complications/etiology/prevention & control ; Colectomy/methods/adverse effects ; Constipation/etiology ; Defecation ; Manometry/methods ; Rectum/surgery ; Organ Sparing Treatments/methods ; },
abstract = {BACKGROUND: The quality of life after surgery for diverticular disease is mainly linked to the presence and severity of postoperative defecatory disorders. These symptoms are frequently related to the sigmoid and rectal denervation following the arterial ligation. The preservation of Inferior Mesenteric Artery performing colorectal resections seems to reduce denervation, which led to a better defecatory function. This study aimed to assessing the efficacy of inferior mesenteric artery preservation following colonic resections for diverticular disease in terms of reduced defecatory disorders and improved quality of life.

METHODS: This is a prospective randomized controlled trial entirely conducted at St. Maria Goretti and St. Andrea Hospitals. Between January 2012 and January 2018 each patient scheduled for sigmoidectomy, left colonic or rectal resection for diverticular disease were included in the study and randomly divided in two groups. Colorectal resections were performed either preserving the inferior mesenteric artery or not. The incurrence of defecatory disorders and their impact on QoL of defecatory disorders were assessed with 6 questionnaires, administered at 6 and12 months and after 6 years from surgery and with an anorectal manometry performed after 6 months and 5 years.

RESULTS: 219 patients were evaluated during the study showing a statistically lower incidence and severity of defecatory disorders in the group of patients whose inferior mesenteric artery was preserved. These defecatory disorders remained stable over the time. The study showed a statistically better quality of life in patients who experienced less defecatory disorders.

CONCLUSION: Inferior Mesenteric Artery preserving in colonic resection for diverticular disease allows to improve defecatory function by reducing the denervated colonic tract. This led to better quality of life and less impairment of daily activities also after 6 years from surgery. The study was registered in ClinicalTrials.gov with number NCT06506552.},
}

Humans
*Mesenteric Artery, Inferior/surgery
Female
Male
*Laparoscopy/methods/adverse effects
Middle Aged
Aged
Prospective Studies
*Quality of Life
Postoperative Complications/etiology/prevention & control
Colectomy/methods/adverse effects
Constipation/etiology
Defecation
Manometry/methods
Rectum/surgery
Organ Sparing Treatments/methods

@article {pmid39803010,
year = {2024},
author = {Ahmed, YA and Manna, R and Thomas, P and Mohamedahmed, AY and Eccersley, J},
title = {A Rare Case of Isolated Diverticular Disease of the Appendix Combined With Uncomplicated Appendicitis.},
journal = {Cureus},
volume = {16},
number = {12},
pages = {e75575},
pmid = {39803010},
issn = {2168-8184},
abstract = {The differential diagnoses for patients presenting with right iliac fossa pain are broad, with appendicitis almost always on the top of the list. Although rare, diverticulosis of the appendix, complicated by inflammation, should be considered in these patients. We report a case of a middle-aged female with right iliac fossa pain with a high inflammatory marker. CT of the abdomen and pelvis showed uncomplicated appendicitis. The patient underwent a diagnostic laparoscopy, which confirmed an inflamed appendix and three small nodules in the body of the appendix. An appendectomy was performed, and histopathology showed diverticulosis of the appendix with appendicitis. She recovered uneventfully, and the follow-up colonoscopy was normal. This report illustrates the complexities associated with diverticular disease of the appendix and its potential to mimic appendicitis and highlights the importance of histopathology examination in these cases.},
}

@article {pmid39787400,
year = {2025},
author = {Sobrado, LF and Schabl, L and Foley, NM and Prien, C and Nahas, SC and Liska, D and Kessler, H and Valente, MA and Steele, SR and Hull, TL},
title = {Deloyers Technique for Restoration of Bowel Continuity Following Extended Left Hemicolectomy: A Comprehensive Analysis of 97 Cases and Literature Review.},
journal = {Diseases of the colon and rectum},
volume = {68},
number = {4},
pages = {466-474},
doi = {10.1097/DCR.0000000000003597},
pmid = {39787400},
issn = {1530-0358},
mesh = {Humans ; *Colectomy/methods ; Male ; Female ; Middle Aged ; Aged ; *Postoperative Complications/epidemiology ; *Anastomosis, Surgical/methods/adverse effects ; Adult ; Ileostomy/methods ; Reoperation/statistics & numerical data/methods ; Colorectal Neoplasms/surgery ; Anastomotic Leak/epidemiology/etiology ; Colon/surgery ; Retrospective Studies ; Aged, 80 and over ; },
abstract = {BACKGROUND: Deloyers technique addresses challenges in restoring bowel continuity after extended left hemicolectomies. Despite being first described in 1958, the technique remains underused, with limited data on long-term outcomes.

OBJECTIVE: To evaluate the indications of surgical and functional outcomes of the Deloyers technique and review existing literature.

DESIGN: Using a prospectively maintained database, patient demographics and perioperative data were collected. A telephone interview was conducted to assess bowel function, and statistical analysis identified factors affecting bowel function.

SETTINGS: Single tertiary care center.

PATIENTS: Patients who underwent the Deloyers technique from January 1995 to February 2023.

RESULTS: A total of 97 patients were included. The most common indications were colorectal cancer (50.5%) and diverticular disease (21.6%). In 53.6% of cases, Deloyers technique was performed at reoperations, and in 70.1% of cases, a diverting loop ileostomy was created. Early surgical complications occurred in 7.2% of patients, including 5 anastomotic leaks, 1 colonic conduit ischemia, and 1 small-bowel obstruction. Late complications occurred in 8.2% of cases, including 6 anastomotic strictures and 2 chronic leaks. There was no perioperative mortality. A total of 40 patients were interviewed and reported an average of 3.5 bowel movements per day and 0.5 at night; 17.5% of patients used bowel stoppers and 52.5% of patients reported that their bowel function did not impact their quality of life. Previous radiotherapy and anastomosis <8 cm from the anal verge were associated with having 4 or more bowel movements per day (p < 0.01).

MAIN OUTCOME MEASURES: Postoperative morbidity and bowel function.

LIMITATIONS: Retrospective analysis of a heterogeneous group of patients with different pathologies and indications for surgery.

CONCLUSIONS: Deloyers technique is a safe and effective alternative for restoring bowel continuity after extended left hemicolectomy. Postoperative functional results are generally satisfactory, with more favorable outcomes noted in patients with higher anastomoses and those who have not undergone prior pelvic radiotherapy. See Video Abstract .

ANTECEDENTES:La técnica de Deloyers aborda los retos que plantea la reconstrucción de la continuidad intestinal tras hemicolectomías izquierdas ampliadas. A pesar de haber sido descrita inicialmente en 1958, la técnica sigue siendo poco utilizada, con datos limitados sobre sus resultados a largo plazo.OBJETIVO:Evaluar las indicaciones y los resultados tanto quirúrgicos como funcionales de la técnica de Deloyers y revisar la bibliografía existente.DISEÑO:Gracias a una base de datos mantenida de forma prospectiva, se recopiló información demográfica y perioperatoria de los pacientes. Se realizó una entrevista telefónica para evaluar la función intestinal y el análisis estadístico identificó los factores que afectaban a la función intestinal.ENTORNO:Un único centro de atención terciaria.PACIENTES:Aquellos sometidos a técnica de Deloyers entre enero de 1995 y febrero de 2023.RESULTADOS:Se incluyó a un total de 97 pacientes. Las indicaciones más frecuentes fueron cáncer colorrectal (50,5%) y enfermedad diverticular (21,6%). En el 53,6% de los casos se realizó DT en las reoperaciones y en el 70,1% se creó una ileostomía de protección. Se encontraron complicaciones quirúrgicas tempranas en 7,2% de los pacientes, incluidas cinco fugas anastomóticas, una isquemia segmentaria de colon y una obstrucción del intestino delgado. Se describen complicaciones tardías en 8,2% de los pacientes, entre ellas 6 estenosis anastomóticas y 2 fugas crónicas. No hubo mortalidad perioperatoria. Se entrevistó a un total de 40 pacientes, que declararon una media de 3,5 deposiciones al día y 0,5 por la noche; el 17,5% utilizó tapones intestinales y el 52,5% de los pacientes declaró que su función intestinal no repercutía en su calidad de vida. La radioterapia previa y la anastomosis a menos de ocho cm del borde anal fueron asociadas con la evacuación de cuatro o más deposiciones al día (p < 0,01).MEDIDAS DE RESULTADOS PRINCIPALES:Morbilidad postoperatoria y función intestinal.LIMITACIONES:Análisis retrospectivo de un grupo heterogéneo de pacientes con diferentes patologías e indicaciones quirúrgicas.CONCLUSIÓN:La técnica de Deloyers es una alternativa segura y eficaz para restaurar la continuidad intestinal tras una hemicolectomía izquierda ampliada. Los resultados funcionales postoperatorios son generalmente satisfactorios, observándose resultados más favorables en pacientes con anastomosis más altas y en aquellos que no han recibido radioterapia pélvica previa. (Traducción-Dr. Xavier Delgadillo).},
}

Humans
*Colectomy/methods
Male
Female
Middle Aged
Aged
*Postoperative Complications/epidemiology
*Anastomosis, Surgical/methods/adverse effects
Adult
Ileostomy/methods
Reoperation/statistics & numerical data/methods
Colorectal Neoplasms/surgery
Anastomotic Leak/epidemiology/etiology
Colon/surgery
Retrospective Studies
Aged, 80 and over

@article {pmid39764487,
year = {2025},
author = {Tursi, A and Procaccianti, G and D'Amico, F and DE Bastiani, R and Turroni, S},
title = {Can gut microbiota explain acute diverticulitis occurrence in patients with symptomatic uncomplicated diverticular disease?.},
journal = {Bioscience of microbiota, food and health},
volume = {44},
number = {1},
pages = {1-3},
pmid = {39764487},
issn = {2186-6953},
abstract = {Why patients with symptomatic uncomplicated diverticular disease (SUDD) may develop acute diverticulitis (AD) is still unknown. We analyzed the gut microbiota (GM) in two SUDD patients, one who did experience SUDD recurrence but not AD occurrence (case 1) and one who did experience AD occurrence during follow-up (case 2). The GM of these patients showed differences in terms of phyla (Firmicutes and Bacteroidota in case 1; Actinobacteriota and Proteobacteria in case 2) and subgenera (Prevotella and Phascolarctobacterium in case 1 and Alloprevotella, Prevotella, Holdemanella, Turicibacter, Eubacterium eligens group, and Dialister in case 2). This novel insight may advance our ecological understanding of this complex disease.},
}

@article {pmid39764150,
year = {2025},
author = {Strigenz, RZ and Dairi, OF and Curley, MA},
title = {Hypercontractile Esophagus Causing Midesophageal Diverticulum.},
journal = {ACG case reports journal},
volume = {12},
number = {1},
pages = {e01586},
pmid = {39764150},
issn = {2326-3253},
abstract = {Esophageal diverticulum (ED) is a rare condition with a clinical presentation that can be variable. Esophageal diverticulum has been associated with motility disorders; however, the association with mid-ED is less clear. Hypercontractile esophagus, also known as jackhammer esophagus, is a rare motility disorder of peristalsis diagnosed by esophageal high-resolution manometry after exclusion of mechanical obstruction. We describe the second reported case of mid-ED secondary to hypercontractile esophagus successfully treated through robotic diverticulectomy with long myotomy. KEYWORDS: esophagus; esophageal manometry; motility; diverticular disease.},
}

@article {pmid39751887,
year = {2025},
author = {Anderesen, CK and Al-Najami, I and Liu, W and Orwoll, E and Folkestad, L},
title = {Risk of Gastrointestinal Diseases in Osteogenesis Imperfecta: A Nationwide, Register-Based Cohort Study.},
journal = {Calcified tissue international},
volume = {116},
number = {1},
pages = {15},
pmid = {39751887},
issn = {1432-0827},
mesh = {Humans ; *Osteogenesis Imperfecta/epidemiology/complications ; Female ; Male ; *Gastrointestinal Diseases/epidemiology ; *Registries/statistics & numerical data ; Denmark/epidemiology ; Cohort Studies ; Adult ; Middle Aged ; Risk Factors ; Adolescent ; Young Adult ; Aged ; Child ; Child, Preschool ; Infant ; },
abstract = {Osteogenesis imperfecta (OI) is a group of rare genetic disorders most commonly caused by reduced amount of biologically normal collagen type I, a structural component of the gastrointestinal tract and abdominal wall. The risk of gastrointestinal (GI) disease in individuals with OI is not well understood, despite GI complaints being frequently reported by the OI population. To investigate the risk of GI diseases in individuals with OI. A Danish nationwide register-based cohort study utilizing data from the Danish National Patient Register and the Danish National Prescription Register. All individuals registered with an OI diagnosis in Denmark from 1995 through 2018, along with a reference population matched 1:5 based on sex, birth year, and month. Sub-hazard ratios (SHR) for peptic ulcer disease, diverticular disease, gastrointestinal cancers, intestinal obstruction with ileus, constipation, abdominal wall hernia, and other reasons for abdominal discomfort. The study included 864 individuals with OI (472 women) and 4,276 in the reference population (2,332 women). The SHR was significantly increased for ulcer (3.28 [95% CI 2.21-4.28]), constipation (2.67 [1.91-3.74]), and hernia (among women: 1.85 [1.22-2.80]). Higher SHRs were also observed for inflammatory bowel disease, biliary and pancreatic diseases, appendicitis, and unspecified abdominal pain. SHRs were not statistically significantly increased for diverticular disease, gastrointestinal cancers, intestinal obstruction with ileus, kidney stones or hemorrhoid disease. Individuals with OI have a higher risk of peptic ulcer disease, constipation, hernia among women, inflammatory bowel diseases, biliary and pancreatic diseases, appendicitis, and unspecified abdominal pain, compared with the general population.},
}

Humans
*Osteogenesis Imperfecta/epidemiology/complications
Female
Male
*Gastrointestinal Diseases/epidemiology
*Registries/statistics & numerical data
Denmark/epidemiology
Cohort Studies
Adult
Middle Aged
Risk Factors
Adolescent
Young Adult
Aged
Child
Child, Preschool
Infant

@article {pmid39745398,
year = {2025},
author = {Pietrzak, AM and Chreptowicz, A and Wieszczy-Szczepanik, P and Mróz, A},
title = {Diverticular inflammation and complication assessment does not predict diverticulitis in asymptomatic individuals.},
journal = {Polish archives of internal medicine},
volume = {135},
number = {2},
pages = {},
doi = {10.20452/pamw.16915},
pmid = {39745398},
issn = {1897-9483},
mesh = {Humans ; Middle Aged ; Female ; Male ; Prospective Studies ; Aged ; *Diverticulitis/diagnosis ; Colonoscopy ; Diverticulitis, Colonic/diagnosis ; Cohort Studies ; Predictive Value of Tests ; Inflammation ; },
abstract = {INTRODUCTION: Recently, a 3‑step endoscopic scale, known as the Diverticular Inflammation and Complication Assessment (DICA), was introduced to predict the course of diverticular disease (DD), yielding some promising outcomes. However, analyses were performed only for symptomatic individuals.

OBJECTIVES: The aim of our study was to prospectively evaluate the predictive value of DICA in asymptomatic individuals with no previous diagnosis of DD who underwent colorectal cancer screening colonoscopy.

PATIENTS AND METHODS: We performed a prospective cohort study. All consecutive individuals, aged 55-65 years undergoing screening colonoscopy in a single center during a 6‑month period were assessed for eligibility. Those with diverticulosis were followed‑up for 12 months. Information on the course of the disease, symptoms, treatment, diverticulitis episodes confirmed by health care professionals, complications, and hospital admissions was obtained via telephone interviews conducted by doctors. Detailed patient data and medical conditions were evaluated.

RESULTS: Out of 3879 participants, 958 (24.7%) had diverticula. Of these, 872 (mean [SD] age, 61 [2] years; 49.8% women) completed the study. About 83.5%, 12.85%, and 3.67% of the patients were classified into the DICA 1, DICA 2, and DICA 3 group, respectively. Diverticulitis occurred in 12 (1.37%) patients. Hospital admission was needed in 5 of them. No surgical interventions were necessary. There were no significant relationships between the DICA score and diverticulitis or hospital admission. Previous abdominal surgery and appendectomy, the presence and severity of pain, bloating, and previous DD treatment were the only factors predisposing to diverticulitis.

CONCLUSIONS: In our cohort, the DICA scale had no predictive value for the occurrence of diverticulitis. Hence, it has a limited predictive value for occurrence of this condition and more studies on bigger cohorts are necessary to test its usefulness.},
}

Humans
Middle Aged
Female
Male
Prospective Studies
Aged
*Diverticulitis/diagnosis
Colonoscopy
Diverticulitis, Colonic/diagnosis
Cohort Studies
Predictive Value of Tests
Inflammation

@article {pmid39742189,
year = {2024},
author = {Siddiqui, A and Zafar, N and Hakiminezhad, M and Jamal, Z and Alam, I and Khawaja, Z},
title = {Beyond the Usual Suspects: Appendiceal Bleeding as the Surprising Cause of Lower Gastrointestinal (GI) Bleeding.},
journal = {Cureus},
volume = {16},
number = {12},
pages = {e76663},
pmid = {39742189},
issn = {2168-8184},
abstract = {Lower gastrointestinal bleeding (LGIB) is a common clinical condition typically associated with diseases like diverticular disease, inflammatory bowel disease, and cancer. However, rarer etiologies such as appendiceal hemorrhage can present similarly, complicating diagnosis and management. This case report discusses a 42-year-old male who presented with severe rectal bleeding. Despite a comprehensive diagnostic workup, including colonoscopy and CT angiography, the underlying cause was identified as an obscure appendiceal hemorrhage. This atypical presentation underscores the importance of considering a broad differential diagnosis, even in cases with seemingly straightforward clinical features. While laparoscopic appendectomy is the standard surgical approach for managing appendiceal hemorrhage, a conservative management strategy was successfully employed in this particular case, highlighting the importance of individualized patient care and judicious clinical decision-making. This case report emphasizes the necessity of a multidisciplinary approach, involving careful clinical assessment, advanced imaging, and endoscopic evaluation, to accurately diagnose and manage complex cases of gastrointestinal bleeding. By recognizing and addressing uncommon etiologies, clinicians can improve patient outcomes and minimize unnecessary interventions.},
}

@article {pmid39736798,
year = {2024},
author = {Tursi, A and Papa, A},
title = {The role of gut microbiota in the pathogenesis of diverticular disease: where are we now?.},
journal = {Genome medicine},
volume = {16},
number = {1},
pages = {153},
pmid = {39736798},
issn = {1756-994X},
mesh = {Humans ; *Diverticular Diseases/microbiology ; *Gastrointestinal Microbiome ; },
abstract = {Diverticular disease (DD) is widespread worldwide. The role of gut microbiota (GM) in DD is not entirely understood. Here we discuss the significance of the current knowledge on GM in the different stages of DD and how crucial these acquisitions are for designing diagnostic and therapeutic trials in this field.},
}

Humans
*Diverticular Diseases/microbiology
*Gastrointestinal Microbiome

@article {pmid39734997,
year = {2024},
author = {Reed, TJ and Zimmer, SK and Nelson, NT and Bush, AM},
title = {Pernicious Pouch of Problems: A Challenging Case of Massive Hemorrhage Secondary to Jejunal Diverticular Bleeding.},
journal = {Cureus},
volume = {16},
number = {11},
pages = {e74590},
pmid = {39734997},
issn = {2168-8184},
abstract = {Small bowel (SB) diverticulosis is an uncommon diagnosis and a rare cause of gastrointestinal (GI) bleeding. A particularly rare form of SB diverticular disease, jejunal diverticulosis, is usually discovered due to complications, such as hemorrhage, obstruction, or perforation. Owing in part to its rarity, jejunal diverticular bleeding can be difficult to identify and treat, resulting in increased morbidity and mortality. Here, we present the case of a 57-year-old female with recurrent massive GI hemorrhage from a jejunal diverticular vessel that was ultimately diagnosed and successfully managed endoscopically.},
}

@article {pmid39726573,
year = {2025},
author = {Correa, N},
title = {Colo-cutaneous fistula in the setting of complicated sigmoid diverticulitis previously managed with percutaneous drainage: a case report.},
journal = {Journal of surgical case reports},
volume = {2025},
number = {1},
pages = {rjae674},
pmid = {39726573},
issn = {2042-8812},
abstract = {Colo-cutaneous fistulas are a rare complication of diverticular disease. Percutaneous drainage offers a promising alternative to surgical intervention in the management of complicated diverticular disease with abscess formation. Recent case studies and literature reviews support its efficacy in achieving abscess resolution and reducing the need for surgery. However, careful patient selection, technical proficiency, and multidisciplinary management are critical to optimizing outcomes. As the body of evidence grows, percutaneous drainage is likely to play an increasingly important role in the therapeutic arsenal against complicated diverticular disease; however, the risk of complications, particularly fistula formation, must be carefully considered. Our case presents a rare incident of a colo-cutaneous fistula occurring after CT-guided percutaneous drainage of a pericolic abscess secondary to perforated sigmoid diverticulitis that failed medical management. The patient ultimately underwent Hartmann's procedure where the diseased sigmoid colon, adhered small bowel, and fistula tract were excised with an end colostomy creation.},
}

@article {pmid39723190,
year = {2024},
author = {Zheng, B and Chen, D and Zeng, H and Lin, S},
title = {Deciphering the gut microbiota's role in diverticular disease: insights from a Mendelian randomization study.},
journal = {Frontiers in cellular and infection microbiology},
volume = {14},
number = {},
pages = {1460504},
pmid = {39723190},
issn = {2235-2988},
mesh = {*Gastrointestinal Microbiome/genetics ; Humans ; *Mendelian Randomization Analysis ; *Genome-Wide Association Study ; *Diverticular Diseases/genetics/microbiology ; Bacteria/classification/genetics/isolation & purification ; },
abstract = {BACKGROUND: Previous studies have indicated a potential association between gut microbiota and diverticular disease. However, the precise nature of this relationship remains unclear. In light of this, we decided to use a bidirectional two-sample Mendelian randomization (MR) study to investigate the causal relationship between gut microbiota and intestinal diverticular disease in greater depth.

METHODS: To investigate the potential causal relationship between gut microbiota and intestinal diverticular disease, we conducted a two-sample MR study in a European ancestry. Genetic instrumental variables for gut microbiota were obtained from a genome-wide association study (GWAS) involving 5,959 participants. Summary statistics for intestinal diverticular disease were sourced from the IEU Open GWAS project, which included data from 5,193 cases and 457,740 controls. The analysis was primarily conducted using the inverse variance weighted method, with additional sensitivity analyses to assess the robustness of the findings.

RESULTS: With regard to the findings, 11 microbial taxa were identified as having a potential causal relationship with intestinal diverticular disease. Specifically, the microbial taxa Caryophanales, Paenibacillaceae, Herbinix, Turicibacter, Turicibacteraceae, and Staphylococcus fleurettii were found to be positively associated with the risk of developing intestinal diverticular disease, while Chromatiales, Arcobacter, Herbidospora, Ligilactobacillus ruminis, and Megamonas funiformis were found to be negatively associated with the risk. Further reverse MR analysis did not reveal a reverse causal effect between these microbial taxa and intestinal diverticular disease.

CONCLUSION: Our MR analyses revealed a potential causal relationship between certain gut microbiota and intestinal diverticular disease, which may provide new directions for future intestinal diverticular disease prevention and treatment strategies.},
}

*Gastrointestinal Microbiome/genetics
Humans
*Mendelian Randomization Analysis
*Genome-Wide Association Study
*Diverticular Diseases/genetics/microbiology
Bacteria/classification/genetics/isolation & purification

@article {pmid39723082,
year = {2024},
author = {Tian, W and Yang, W and Wang, X and Yang, Y},
title = {Exploring the Impact of Dietary Factors on Intestinal Diverticular Disease: A Mendelian Randomization Approach.},
journal = {Food science & nutrition},
volume = {12},
number = {12},
pages = {10859-10866},
pmid = {39723082},
issn = {2048-7177},
abstract = {Dietary habits significantly influence the development of intestinal diverticular disease (IDD), a common gastrointestinal condition primarily affecting the colon. We performed a Mendelian randomization (MR) analysis on 20 diet-related factors using data from the UK Biobank. IDD cases (n = 33,618) and controls (n = 329,381) were obtained from the FinnGen Biobank. Three key MR methods were applied: the inverse-variance-weighted (IVW) method as the primary approach to estimate causal relationships, along with the weighted median (WM) and MR-Egger methods. Significant associations were found for pork intake (β = 1.06, p = 0.00244), nonoily fish intake (β = 0.709, p = 0.0449), oily fish intake (β = 0.246, p = 0.0222), and dried fruit intake (β = -0.953, p < 0.0001). After false discovery rate (FDR) adjustment, pork intake (q = 0.0244) and dried fruit intake (q < 0.0001) remained significant. Our results indicate that while pork and certain types of fish intake may elevate the risk of IDD, dried fruit intake may offer a protective effect. These findings highlight the potential of dietary changes in IDD prevention and management, though further research across diverse populations is needed.},
}

@article {pmid39716092,
year = {2024},
author = {Chapman, JA and Wroot, E and Brown, T and Beck, LC and Embleton, ND and Berrington, JE and Stewart, CJ},
title = {Characterising the metabolic functionality of the preterm neonatal gut microbiome prior to the onset of necrotising enterocolitis: a pilot study.},
journal = {BMC microbiology},
volume = {24},
number = {1},
pages = {533},
pmid = {39716092},
issn = {1471-2180},
mesh = {Humans ; *Enterocolitis, Necrotizing/microbiology/metabolism ; *Gastrointestinal Microbiome ; Pilot Projects ; Infant, Newborn ; *Infant, Premature ; Female ; Male ; Bacteria/classification/metabolism/isolation & purification/genetics ; Feces/microbiology ; Case-Control Studies ; Metagenome ; },
abstract = {BACKGROUND: Necrotising enterocolitis (NEC) is a devastating bowel disease that primarily occurs in infants born prematurely and is associated with abnormal gut microbiome development. While gut microbiome compositions associated with NEC have been well studied, there is a lack of experimental work investigating microbiota functions and their associations with disease onset. The aim of this pilot study was to characterise the metabolic functionality of the preterm gut microbiome prior to the onset of NEC compared with healthy controls.

RESULTS: Eight NEC infants were selected of median gestation 26.5 weeks and median day of life (DOL) of NEC onset 20, with one sample used per infant, collected within one to eight days (median four) before NEC onset. Each NEC case was matched to a control infant based on gestation and sample DOL, the main driver of microbiome composition in this population, giving a total cohort of 16 infants for this study. Dietary exposures were well matched. The microbiota of NEC and control infants showed similar wide-ranging metabolic functionalities. All 94 carbon sources were utilised to varying extents but NEC and control samples clustered separately by supervised ordination based on carbon source utilisation profiles. For a subset of eight samples (four NEC, four control) for which pre-existing metagenome data was available, microbiome composition was found to correlate significantly with metabolic activity measured on Biolog plates (p = 0.035). Comparisons across all 16 samples showed the NEC microbiota to have greater utilisation of carbon sources that are the products of proteolytic fermentation, specifically amino acids. In pairwise comparisons, L-methionine was highly utilised in NEC samples, but poorly utilised in controls (p = 0.043). Carbon sources identified as discriminatory for NEC also showed a greater enrichment for established markers of inflammatory disease, such as inflammatory bowel disease, irritable bowel syndrome and diverticular disease.

CONCLUSIONS: Before NEC onset, the preterm gut microbiota showed greater metabolic utilisation of amino acids, potentially indicating a shift from predominantly saccharolytic to proteolytic fermentation. Products of amino acid breakdown could therefore act as biomarkers for NEC development. A larger study is warranted, ideally with infants from multiple sites.},
}

Humans
*Enterocolitis, Necrotizing/microbiology/metabolism
*Gastrointestinal Microbiome
Pilot Projects
Infant, Newborn
*Infant, Premature
Female
Male
Bacteria/classification/metabolism/isolation & purification/genetics
Feces/microbiology
Case-Control Studies
Metagenome

@article {pmid39712703,
year = {2024},
author = {Orgovan, JM and Dodson, BD},
title = {Colouterine Fistula: A Rare Presentation of Severe Diverticular Disease.},
journal = {Cureus},
volume = {16},
number = {11},
pages = {e74162},
pmid = {39712703},
issn = {2168-8184},
abstract = {Colouterine fistula as a sequela of diverticulitis is an extremely rare complication due to the extraordinarily thick layer of myometrium of the uterus. Because of this, an aggressive clinical evaluation is required to rule out other potential causes of fistula formation such as malignancy. However, imaging and laboratory techniques may be inconclusive, and surgery with pathologic analysis may be required for a definitive diagnosis. The case presented here illustrates the atypical presentation of a 63-year-old woman with acutely symptomatic, severely extensive diverticular disease with resultant colouterine fistula. The patient underwent exploratory laparotomy, sigmoidectomy with end colostomy, appendectomy, and total abdominal hysterectomy with bilateral salpingo-oophorectomy. Eventually, she was discharged with an excellent prognosis and had an uneventful recovery. This case is being presented because of the rarity of the disease course as well as the complexity of the decision-making and surgical approach that resulted in patient recovery.},
}

@article {pmid39697924,
year = {2024},
author = {Xicohtencatl, S and Durango, D and Damacio, RE and Cabrera, D},
title = {Management of Lumbar Abscess Secondary to Colocutaneous Fistula From Complicated Diverticular Disease Using Negative Pressure Therapy.},
journal = {Cureus},
volume = {16},
number = {11},
pages = {e73871},
pmid = {39697924},
issn = {2168-8184},
abstract = {Diverticular disease is a common gastrointestinal condition with rising prevalence. Complications, such as fistulas, are rare but significant, often requiring innovative treatment strategies. This case report examines the use of negative pressure wound therapy (NPWT) with instillation (VERAFLO®, KCI, an Acelity Company, San Antonio, Texas) and antiseptic solution (VASHE®, Urgo Medical North America LLC, Fort Worth, Texas) in treating a colocutaneous fistula secondary to complicated diverticular disease. A 43-year-old male presented with lumbar pain and erythema. Computed tomography (CT) scans revealed a left-sided collection with gas, suggesting a colocutaneous fistula. Initial management included drainage, antibiotics, and NPWT. Follow-up involved transrectal contrast CT to assess the fistula tract and subsequent colonoscopy to confirm resolution. NPWT with VERAFLO® was applied for 20 days, followed by wound closure. Two-month follow-up showed no evidence of fistula on colonoscopy, confirming successful treatment. NPWT can be an effective alternative for treating colocutaneous fistulas in diverticular disease, promoting wound healing and reducing infection. Further research is warranted to explore its broader applications in gastrointestinal fistulas.},
}

@article {pmid39692883,
year = {2024},
author = {Hamid, M and Zaman, S and Mostafa, OES and Deutsch, A and Bird, J and Kawesha, A and Reay, M and Banga, I and Williams, A and Waterland, P and Akingboye, A},
title = {Low vs. conventional intra-abdominal pressure in laparoscopic colorectal surgery: a prospective cohort study.},
journal = {Langenbeck's archives of surgery},
volume = {410},
number = {1},
pages = {12},
pmid = {39692883},
issn = {1435-2451},
mesh = {Humans ; Male ; Female ; *Laparoscopy/methods/adverse effects ; Aged ; Middle Aged ; Prospective Studies ; *Pressure ; Length of Stay ; Postoperative Complications/etiology ; Cohort Studies ; Pain, Postoperative ; },
abstract = {PURPOSE: Low intraabdominal pressure (IAP) during laparoscopy is associated with improved post-operative outcomes across a variety of surgical specialties. A prospective cohort study was undertaken to assess post-operative outcomes in patients undergoing laparoscopic colorectal surgery (LCRS) with low (8mmHg) versus conventional (15mmHg) IAP.

METHODS: A prospective real-world observational study of patients undergoing LCRS in a single-centre, between June 2020 and June 2023 was performed. Operative procedures for diverse colonic pathology such as diverticular disease, inflammatory bowel disease (IBD), and colorectal cancers (CRC) were included. The evaluated primary outcomes were post-operative pain, return of gastrointestinal motility, and length of hospital stay. Secondary outcomes were the overall safety profile including intra- and post-operative complications and morbidity. Outcomes of interest were investigated using multivariate analysis.

RESULTS: A total of 120 patients were included of which 69 (57.5%) were male. Median age and BMI of the cohort was 67 years (51-75 years) and 27 kg/m[2] (24-32 kg/m[2]), respectively. 61 (50.8%) patients were categorised as an ASA grade 3. Two (1.7%) patients had diverticular disease; 31 (25.9%) had IBD, and 87 (72.4%) were operated on for colonic malignancy. Low IAP (8mmHg) was used in 53 (44.2%) cases, whilst the remainder (55.8%) had IAP set at 15mmHg (conventional). Low-pressure surgery was associated with improved intraoperative lung compliance (p < 0.001) and peak inspiratory pressures up to 6 h (p < 0.001); reduced analgesic requirement (p ≤ 0.028), and decreased postoperative pain both at rest (p = 0.001) and on exertion (p < 0.001). Moreover, low IAP was associated with an earlier time to pass flatus postoperatively (p = 0.047) with no significant difference in length of hospital stay (p = 0.574). Additionally, no significant difference was observed between the groups for outcomes including median operating time (p = 0.089), conversion to open surgery (p = 0.056), overall complication rate (p = 0.102), and 90-day mortality (p = 0.381).

CONCLUSION: Low IAP use during LCRS is feasible with a comparable safety profile to conventional laparoscopy. Intra-operative respiratory physiology is improved with reduced postoperative pain and analgesic requirement, and earlier time to pass flatus. Future rationally designed; well-powered, randomised trials are needed to understand the benefits of low intra-peritoneal pressure during laparoscopic colorectal resections.},
}

Humans
Male
Female
*Laparoscopy/methods/adverse effects
Aged
Middle Aged
Prospective Studies
*Pressure
Length of Stay
Postoperative Complications/etiology
Cohort Studies
Pain, Postoperative

@article {pmid39677849,
year = {2024},
author = {Chasman, DI and Guo, Y and Chan, AT and Rist, PM and Staller, K},
title = {Shared Genetics of Migraine and Gastrointestinal Disorders Implicates Underlying Neurologic Mechanisms Yet Heterogeneous Etiologies.},
journal = {Neurology. Genetics},
volume = {10},
number = {6},
pages = {e200201},
pmid = {39677849},
issn = {2376-7839},
support = {/WT_/Wellcome Trust/United Kingdom ; R61 NS122074/NS/NINDS NIH HHS/United States ; },
abstract = {BACKGROUND AND OBJECTIVES: Migraine is strongly comorbid with irritable bowel syndrome (IBS), one of several gastrointestinal (GI) conditions that are distinguished by symptomatic profiles that are partly overlapping. Potential shared mechanisms of migraine and the GI conditions were investigated by assessing shared genetics on a genome-wide basis.

METHODS: Analyses leveraged genome-wide summary statistics from large-scale genetic studies for migraine, including by aura status, IBS, peptic ulcer disease (PUD), gastrointestinal reflux (GERD), functional dyspepsia (FD), diverticular disease (DD), and the immune-related inflammatory bowel disease (IBD) or its constituents, ulcerative colitis (UC) and Crohn disease (CD). Genetic correlation was evaluated on a genome-wide basis and at independent local regions, including those related to therapeutic targeting of serotonin and the calcitonin gene-related peptide. Genetic correlation was assessed for enrichment at genes according to tissue specificity of gene expression. Potential causality between migraine and the GI conditions was assessed by Mendelian randomization.

RESULTS: Genetic correlation with migraine was strongly significant among the nonimmune GI disorders, maximally for IBS (rg [SE] = 0.37[0.04], p = 10[-21]) and minimally for DD (0.18 (0.04), 7.5 × 10[-7]), but null for IBD. There were distinct patterns of local genetic sharing with migraine across the GI conditions at 22 significant segments of the genome, 7 of which were novel for either migraine or GI or both. Enrichment analysis suggested involvement of the CNS in genetic overlap of GERD, IBS, and PUD with migraine. There was local genetic sharing with migraine at CALCA/CALCB (encoding calcitonin gene-related peptide [CGRP]) in an inverse sense for GERD and PUD, but with concordance and greater significance for DD, IBD, and UC. Mendelian randomization supported causal effects of PUD, GERD and particularly DD (OR[SE] = 1.90 (1.35-2.68, p = 2.2 × 10[-4]) on migraine, but not of migraine on any GI condition.

DISCUSSION: Genetic sharing of migraine and non-immune-related GI disorders was extensive yet distinct across GI disorders that have overlapping symptoms, with enrichment signals that imply neurologic mechanisms. Causal effects of some GI conditions on migraine were supported. A concordant local correlation at CALCA/CALCB of migraine with both DD and the immune-related disorders suggests potential benefit to these conditions from repurposed migraine therapeutics targeting CGRP.},
}

@article {pmid39665227,
year = {2025},
author = {Ferrara, F and Grassi, N and Graceffa, G and Macaione, I and Pantuso, G},
title = {Routine histopathological examination in patients undergoing sigmoidectomy for diverticular disease: Are we ready to avoid it?.},
journal = {Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland},
volume = {27},
number = {1},
pages = {e17264},
doi = {10.1111/codi.17264},
pmid = {39665227},
issn = {1463-1318},
}

@article {pmid39648791,
year = {2024},
author = {de Silva, AP and Nuwanshika, N and Dassanayake, U and Niriella, MA and Ranasinghe, P and de Silva, HJ},
title = {Colonic diverticular disease revisited.},
journal = {Expert review of gastroenterology & hepatology},
volume = {18},
number = {11},
pages = {745-752},
doi = {10.1080/17474124.2024.2438708},
pmid = {39648791},
issn = {1747-4132},
mesh = {Humans ; Risk Factors ; *Diverticulosis, Colonic/therapy/epidemiology/diagnosis/physiopathology ; Diverticulitis, Colonic/therapy/epidemiology/diagnosis/physiopathology ; Prevalence ; Biomarkers ; Disease Progression ; Incidence ; },
abstract = {INTRODUCTION: Diverticular disease, including diverticulosis and diverticulitis, presents a significant health concern globally, with increasing prevalence in Western societies and emerging trends in Asia. The incidence of diverticulitis, is on the rise, leading to significant morbidity and healthcare costs.

AREAS COVERED: A literature search was conducted using the PubMed database, and studies published between 1995 and 2024 were selected based on their relevance to the overall understanding of disease. This review investigates the clinical spectrum, classification, and management strategies of diverticular disease, focusing particularly on evolving trends in diagnosis and treatment. Discussions regarding the prevalence of diverticulosis, the identification of risk factors associated with disease progression, recent advancements in research, and the utilization of biomarkers in disease monitoring and treatment decision-making are considered in detail.

EXPERT OPINION: The discourse on diverticular disease underscores the pressing need for tailored management strategies and innovative treatments. Understanding the intricacies of the disease's pathophysiology is paramount for effective intervention. Recent advances in diagnostic imaging and biomarker identification are promising, yet more research is imperative to further refine patient care. Advances in these areas hold the potential for significantly improving outcomes in disease management.},
}

Humans
Risk Factors
*Diverticulosis, Colonic/therapy/epidemiology/diagnosis/physiopathology
Diverticulitis, Colonic/therapy/epidemiology/diagnosis/physiopathology
Prevalence
Biomarkers
Disease Progression
Incidence

@article {pmid39647416,
year = {2025},
author = {Saidi, A and Khefacha, F and Touati, MD and Othmane, MRB and Belhadj, A and Chebbi, F},
title = {Appendiceal diverticulitis: A rare case report highlighting diagnostic challenges and complication risks.},
journal = {International journal of surgery case reports},
volume = {126},
number = {},
pages = {110697},
pmid = {39647416},
issn = {2210-2612},
abstract = {INTRODUCTION AND IMPORTANCE: Diverticular disease of the appendix is a rare condition often mistaken for acute appendicitis, with most cases diagnosed incidentally during histopathology, underscoring the importance of comprehensive pathological evaluation for accurate diagnosis.

CASE PRESENTATION: A 34-year-old male presented with one day of periumbilical pain migrating to the right iliac fossa, without vomiting or bowel changes. Clinical examination revealed tenderness in the RIF. Laboratory tests indicated a syndrome inflammatoire biologique. Ultrasound and CT scans suggested appendicular diverticulitis. Laparoscopic appendectomy confirmed an inflamed diverticulum. The patient had an uncomplicated recovery and was discharged on day 1, with no anomalies noted at one-year follow-up.

CLINICAL DISCUSSION: There are two types of appendiceal diverticula: congenital and acquired. Congenital diverticula result from outpouching of all appendiceal layers, while acquired diverticula arise from increased pressure due to factors like fecaliths or tumors. Risk factors for diverticular disease of the appendix (DDA) include male gender and age over 30. Diagnosing appendiceal diverticulitis preoperatively is challenging, often relying on ultrasound and CT findings. Appendicectomy is the preferred treatment, with pathological evaluation necessary for diagnosis. Prophylactic appendicectomy is advised for incidentally detected diverticular disease due to associated risks of perforation and malignancy.

CONCLUSION: The differential diagnosis of appendiceal diverticulitis is a rare but significant condition with increased risks of complications and malignancy. Early diagnosis and surgical intervention are crucial for effective management, highlighting the importance of thorough pathological evaluation in confirming the diagnosis.},
}

@article {pmid39606539,
year = {2024},
author = {Dang, N and Kay, S},
title = {Acute Large Bowel Obstruction Post Umbilical Hernia Repair Surgery: A Case Report.},
journal = {Cureus},
volume = {16},
number = {10},
pages = {e72566},
pmid = {39606539},
issn = {2168-8184},
abstract = {While large bowel obstruction (LBO) is a less common cause of bowel obstruction, it has a broad range of differentials. Its most common etiology in the United States is colorectal adenocarcinoma. Patients usually present with diffuse abdominal pain, constipation, abdominal distension, and nausea. Abdominal X-rays can quickly assess bowel dilation, but a CT scan is the gold standard to determine the location and severity of the blockage. The treatment can range from IV fluid to emergent colectomy. A 41-year-old male with a history of bronchitis and hypertension presented for a surgical consult six days post-incarcerated umbilical hernia repair. The patient complained of nausea, diffuse abdominal distension and tenderness, and inability to pass gas. Physical examination revealed a severely distended abdomen with rebound and guarding at the lower right quadrant. CT scan showed severely dilated ascending colon and cecum along with pneumatosis. There was also an obstructing mass at the sigmoid colon. A diagnosis of severe LBO with impending perforation was made, and the patient underwent emergent exploratory laparotomy. Subtotal colectomy was done with anastomosis between the ileum and sigmoid colon. The pathology report showed an 8.0 cm dilated cecum, necrosis of the ascending colon, and diverticulitis with scar fibrosis along the wall of the colonic membrane. The patient had an ileus and kidney injury postoperatively but they subsequently resolved. Diverticulitis is historically common in the elderly population, but recent studies have shown a rising incidence among younger individuals. It is a common cause of obstruction but rarely causes severe complications like pneumatosis and perforation that require emergent surgery. When occluded, the mass and patent ileocecal valve can cause closed-loop bowel syndrome. Even though an unhealthy diet is a known trigger for diverticulitis, surgery is possibly another factor in rare cases. Patients of all ages should be educated on the symptoms of diverticular disease, and surgical monitoring is key in those with known diverticulosis.},
}

@article {pmid39560541,
year = {2024},
author = {Alshandeer, MH and Abd El Maksoud, WM and Abbas, KS and Al Amri, FS and Alghamdi, MA and Alzahrani, HA and Dalboh, A and Bawahab, MA and Asiri, AJ and Assiri, Y},
title = {Does type II diabetes mellitus increase the morbidity of patients with diverticulitis?.},
journal = {Medicine},
volume = {103},
number = {46},
pages = {e40567},
pmid = {39560541},
issn = {1536-5964},
mesh = {Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; *Diabetes Mellitus, Type 2/complications/epidemiology ; Saudi Arabia/epidemiology ; Aged ; Adult ; Diverticulitis, Colonic/complications/epidemiology ; Length of Stay/statistics & numerical data ; Age Factors ; Risk Factors ; },
abstract = {Diverticular disease is a common condition that has numerous complications. Understanding the impact of diabetes mellitus (DM) on these complications, especially diverticulitis, is crucial for optimizing patient care. This study aimed to determine the relationship between type II DM and the complications of colonic diverticulitis. A retrospective cohort study was conducted on 158 patients complaining of diverticulitis at Asir Central Hospital, Abha, Saudi Arabia, between January 2013 and December 2023. Data on gender, age, and chronic diseases, especially DM, were collected. Data retrieved regarding diverticulitis included the involved segment, complications, Hinchey classification, and management. We classified the patients into groups A for nondiabetics and B for diabetics. We analyzed the data using descriptive statistics, chi-square tests, t tests, and analysis of variance. Diabetic patients were significantly older than their nondiabetic counterparts. Diabetic patients showed a significantly higher complication rate (62.5%) and a higher degree of Hinchey classification compared to nondiabetic patients (43.7%). Furthermore, in comparison to individuals without diabetes, they were hospitalized for a considerably extended period (8.06 ± 7.38 days vs 5.26 ± 5.90 days, respectively). In addition, surgical intervention was observed to be considerably more common in patients with diabetes (46.9%) than in those without diabetes (16.5%). The study showed that DM adversely affected patients with diverticulitis. A greater incidence of complications and a higher category of Hinchey classification were associated with DM compared to nondiabetics. Additionally, diabetics underwent more surgical interventions and had longer hospital stays. Diabetics with diverticulitis require particular care to prevent severe complications.},
}

Humans
Male
Female
Retrospective Studies
Middle Aged
*Diabetes Mellitus, Type 2/complications/epidemiology
Saudi Arabia/epidemiology
Aged
Adult
Diverticulitis, Colonic/complications/epidemiology
Length of Stay/statistics & numerical data
Age Factors
Risk Factors

@article {pmid39533633,
year = {2024},
author = {Yoshikawa, M and Asaba, K},
title = {CCN3/NOV as a potential therapeutic target for diverticular disease: A proteome-wide Mendelian randomization study.},
journal = {Medicine},
volume = {103},
number = {45},
pages = {e40467},
pmid = {39533633},
issn = {1536-5964},
mesh = {Humans ; *Mendelian Randomization Analysis ; *Genome-Wide Association Study ; *Nephroblastoma Overexpressed Protein/genetics/metabolism/blood ; *Diverticular Diseases/genetics ; Proteome/metabolism ; Quantitative Trait Loci ; Genetic Predisposition to Disease ; Female ; Polymorphism, Single Nucleotide ; Male ; },
abstract = {Genome-wide association studies (GWAS) identified over 100 susceptibility loci and candidate causal genes for diverticular disease (DD) at the transcriptional level. However, effective therapeutics or preventions based on underlying disease mechanisms remain to be elucidated. In this study, we explored potential causal genes for DD at the protein level. We used 2 GWAS summary statistics of DD; 1 was obtained from the United Kingdom Biobank (UKBB) with 31,917 cases and 419,135 controls, and the other from the FinnGen consortium with 30,649 cases and 301,931 controls. For the primary analysis, we employed proteome-wide Mendelian randomization (MR) studies using 738 cis-acting protein quantitative trait loci (pQTLs) for 735 plasma proteins from the 5 published studies. For external validation, we conducted 2-sample MR analyses using plasma pQTLs of the screened proteins from another study by deCODE genetics. Moreover, we performed a series of sensitivity analyses including reverse MR and Bayesian colocalization tests. The primary MR identified 4 plasma proteins that were associated with DD risk including CCN3/NOV (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97-0.99; P = 1.2 × 10-11 for UKBB. OR, 0.73; 95% CI, 0.66-0.81; P = 7.2 × 10-10 for FinnGen). The validation MR well replicated the primary result of CCN3/NOV (OR, 0.95; 95% CI, 0.93-0.96; P = 1.9 × 10-11 for UKBB. OR, 0.43; 95% CI, 0.33-0.56; P = 7.0 × 10-10 for FinnGen). Sensitivity analyses supported the causal association. We prioritized plasma CCN3/NOV protein as a protective factor for DD for follow-up functional studies to elucidate the disease mechanisms and therapeutics.},
}

Humans
*Mendelian Randomization Analysis
*Genome-Wide Association Study
*Nephroblastoma Overexpressed Protein/genetics/metabolism/blood
*Diverticular Diseases/genetics
Proteome/metabolism
Quantitative Trait Loci
Genetic Predisposition to Disease
Female
Polymorphism, Single Nucleotide
Male

@article {pmid39525910,
year = {2025},
author = {Hsieh, SL and Grabill, N and Louis, M and Kuhn, B},
title = {Complicated diverticulitis: Diagnostic precision and surgical solutions in a patient with chronic kidney disease.},
journal = {Radiology case reports},
volume = {20},
number = {1},
pages = {346-351},
pmid = {39525910},
issn = {1930-0433},
abstract = {Diverticulitis, an inflammation of diverticula in the colon, can lead to severe complications such as perforation and abscess formation. A 42-year-old female with polycystic kidney disease and chronic kidney disease stage III presented with severe abdominal pain, fever, and inability to tolerate oral intake. The patient was a previous smoker who smoked 0.5 packs per day for 25 years. Initial evaluation revealed leukocytosis and elevated creatinine. A CT scan identified pneumoperitoneum and mild sigmoid diverticulitis, suggesting a perforated viscus. She underwent urgent exploratory laparotomy, which confirmed the CT findings and resulted in an appendectomy, sigmoid colon resection, and ostomy creation. Postoperatively, the patient faced complications, including recurrent pneumoperitoneum and subcutaneous emphysema, detected through follow-up CT scans, leading to further surgical interventions. CT imaging was pivotal in diagnosing, monitoring, and guiding treatment, with noncontrast CT being beneficial given her renal impairment. Early diagnosis and CT imaging are crucial in managing complicated diverticulitis. Postoperative monitoring with CT scans is essential for detecting complications. Follow-up care should include regular colonoscopies to assess diverticular disease and dietary modifications to prevent recurrence. Combining clinical, surgical, and radiologic data ensures effective management and improves patient outcomes.},
}

@article {pmid39514266,
year = {2025},
author = {Tursi, A and Turroni, S and De Bastiani, R and Procaccianti, G and D'Amico, F and Allegretta, L and Antonino, N and Baldi, E and Casamassima, C and Casella, G and Ciuffi, M and De Bastiani, M and Lazzarotto, L and Licci, C and Mancuso, M and Penna, A and Pranzo, G and Sanna, G and Tosetti, C and Zamparella, M and Picchio, M},
title = {Gut microbiota in symptomatic uncomplicated diverticular disease stratifies by severity of abdominal pain.},
journal = {European journal of gastroenterology & hepatology},
volume = {37},
number = {2},
pages = {147-153},
doi = {10.1097/MEG.0000000000002884},
pmid = {39514266},
issn = {1473-5687},
mesh = {Humans ; *Gastrointestinal Microbiome ; Female ; *Abdominal Pain/microbiology ; Male ; Retrospective Studies ; Middle Aged ; Aged ; *Severity of Illness Index ; *Feces/microbiology ; Pain Measurement ; Bacteria/isolation & purification/classification/genetics ; Aged, 80 and over ; Dysbiosis/microbiology ; },
abstract = {OBJECTIVE: Patients with symptomatic uncomplicated diverticular disease (SUDD) may have a disrupted gut microbiota. However, current data are from small sample studies, and reported associations vary widely across studies. We aimed to profile the fecal microbiota in SUDD patients enrolled in primary care.

METHODS: A retrospective study was conducted in SUDD (N  = 72) and asymptomatic diverticulosis (AD) (N  = 30), the latter serving as a control group.

RESULTS: No significant differences in alpha and beta diversity were found between SUDD and AD, but SUDD was discriminated by a higher relative abundance of the family Streptococcaceae and the genera Alistipes , Agathobacter , and Butyricimonas . Interestingly, the gut microbiota of SUDD patients stratified by the severity of abdominal pain [according to the visual analog scale (VAS)]. In particular, higher diversity and health-associated taxa (such as Bifidobacterium , Eubacterium coprostanoligenes group, and Dorea) characterized mild (VAS score 1-3) SUDD, Proteobacteria , Veillonellaceae and Blautia moderate (VAS score 4-7) SUDD, and Prevotellaceae and Megasphaera severe (VAS score 8-10) SUDD.

CONCLUSION: Our analysis suggests that specific taxa may be related to SUDD, but the associations vary depending on the severity of abdominal pain. In addition to advancing our ecological understanding of this complex disease, our findings may pave the way for the incorporation of gut microbiota profiling into clinical practice to aid patient management, including stratification and treatment.},
}

Humans
*Gastrointestinal Microbiome
Female
*Abdominal Pain/microbiology
Male
Retrospective Studies
Middle Aged
Aged
*Severity of Illness Index
*Feces/microbiology
Pain Measurement
Bacteria/isolation & purification/classification/genetics
Aged, 80 and over
Dysbiosis/microbiology

@article {pmid39505824,
year = {2024},
author = {Petrusic, A and Mongelli, F and Sabbatini, F and Christoforidis, D and Pini, R and Merlo, E and Popeskou, SG and La Regina, D and Iaquinandi, F},
title = {Is histopathological analysis necessary in patients undergoing sigmoidectomy for diverticular disease? A retrospective study.},
journal = {Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland},
volume = {},
number = {},
pages = {},
doi = {10.1111/codi.17220},
pmid = {39505824},
issn = {1463-1318},
abstract = {AIM: The purpose of this study was to assess the utility of routine histopathological examination in patients undergoing elective sigmoidectomy for diverticular disease after full colonoscopy 1 year prior to surgery.

METHODS: We retrospectively analysed medical records of all patients undergoing sigmoidectomy for diverticular disease with a documented colonoscopy within 1 year before surgery from January 2013 to December 2023. We collected preoperative, intraoperative and postoperative data of all patients. The primary endpoint was the percentage of patients with an unexpectedly abnormal histopathological report compared to colonoscopy.

RESULTS: During the study period, 207 patients undergoing sigmoidectomy for diverticular disease were included. Mean age was 62.7 ± 13.0 years and 97 (46.9%) patients were men. In eight (3.9%) cases an unexpected finding was noted on the histopathological examination: five (2.4%) of them were hyperplastic polyps with no dysplasia and no clinical relevance, two (1.0%) were polyps with low-grade dysplasia and in one case (0.5%) a diffuse large B-cell lymphoma was present in a patient with history of lymphoma treated in the past 10 years. The Goodman and Kruskal's G index was 0.953 (95% lower limit of 0.913), which indicated high concordance between the colonoscopy and the definitive histopathological examination.

CONCLUSIONS: In our series, the preoperative colonoscopy reliably predicted the result of the histopathological specimen findings in patients undergoing sigmoidectomy for diverticular disease. Only one (0.5%) high-risk patient had an unexpected clinically significant finding. Therefore, routine histopathological examination may not be justified for all patients.},
}

@article {pmid39495781,
year = {2025},
author = {Miller, A and Anderson, JC},
title = {Strategies, Technologies, and Tips for Successful Cecal Intubation.},
journal = {Journal of clinical gastroenterology},
volume = {59},
number = {1},
pages = {16-23},
doi = {10.1097/MCG.0000000000002096},
pmid = {39495781},
issn = {1539-2031},
mesh = {Humans ; *Colonoscopy/methods ; *Cecum ; Colonoscopes ; Colon ; },
abstract = {Successful cecal intubation is crucial in ensuring a complete evaluation of the colonic mucosa. Although completion of colonoscopies should be successful in close to 100% of all examinations in the hands of experienced gastroenterologists, there are some patients with colons which can be difficult to navigate. Factors such as older age, presence of diverticular disease, as well as high or low body mass index can present challenges for endoscopists. Challenges can be divided into those that are left sided and are associated with severe angulations of the colon versus those that are right sided and present as redundant colons. Both require different strategies to achieve completion. This review will cover methods, technologies as well the evolution of colonoscope insertion tubes which can help in navigating colons, especially those that are challenging. There will also be a discussion about basic principles and techniques that should be employed in all colonoscopies.},
}

Humans
*Colonoscopy/methods
*Cecum
Colonoscopes
Colon

@article {pmid39492836,
year = {2024},
author = {Morasso, C and Daveri, E and Bonizzi, A and Truffi, M and Colombo, F and Danelli, P and Albasini, S and Rivoltini, L and Mazzucchelli, S and Sorrentino, L and Corsi, F},
title = {Raman spectroscopy on dried blood plasma allows diagnosis and monitoring of colorectal cancer.},
journal = {MedComm},
volume = {5},
number = {11},
pages = {e774},
pmid = {39492836},
issn = {2688-2663},
abstract = {Colorectal cancer (CRC) remains challenging to diagnose, necessitating the identification of a noninvasive biomarker that can differentiate it from other conditions such as inflammatory bowel diseases (IBD) and diverticular disease (DD). Raman spectroscopy (RS) stands out as a promising technique for monitoring blood biochemical profiles, with the potential to identify distinct signatures identifying CRC subjects. We performed RS analysis on dried plasma from 120 subjects: 32 CRC patients, 37 IBD patients, 20 DD patients, and 31 healthy controls. We also conducted longitudinal studies of CRC patient's postsurgery to monitor the spectral changes over time. We identified six spectral features that showed significant differences between CRC and non-CRC patients, corresponding to tryptophan, tyrosine, phenylalanine, lipids, carotenoids, and disulfide bridges. These features enabled the classification of CRC patients with an accuracy of 87.5%. Moreover, longitudinal analysis revealed that the spectral differences normalized over 6 months after surgery, indicating their association with the presence of the disease. Our study demonstrates the potential of RS to identify specific biomolecular signatures related to CRC. These results suggest that RS could be a novel screening and monitoring tool, providing valuable insights for the development of noninvasive and accurate diagnostic methods for CRC.},
}

@article {pmid39475015,
year = {2024},
author = {Dharmavaram, S and Unnam, S and Joacquim, MA},
title = {Rectosigmoid Endometriosis Causing Large Bowel Obstruction.},
journal = {British journal of hospital medicine (London, England : 2005)},
volume = {85},
number = {10},
pages = {1-7},
doi = {10.12968/hmed.2024.0118},
pmid = {39475015},
issn = {1750-8460},
mesh = {Humans ; *Endometriosis/complications/surgery ; *Intestinal Obstruction/etiology/surgery ; Female ; *Sigmoid Diseases/etiology/surgery ; *Rectal Diseases/etiology/surgery ; Adult ; Tomography, X-Ray Computed ; },
abstract = {Large bowel obstruction is most commonly due to colorectal carcinoma, diverticular disease or volvulus. Rare causes of large bowel obstruction like endometriosis may occur in premenopausal women and diagnosis of large bowel endometriosis can be challenging to confirm preoperatively. Hence, clinicians should maintain a high index of suspicion for rare causes of large bowel obstruction like endometriosis. This may require complete surgical resection of the involved bowel to eliminate the risk of local recurrence.},
}

Humans
*Endometriosis/complications/surgery
*Intestinal Obstruction/etiology/surgery
Female
*Sigmoid Diseases/etiology/surgery
*Rectal Diseases/etiology/surgery
Adult
Tomography, X-Ray Computed

@article {pmid39467839,
year = {2024},
author = {},
title = {Diagnosis and management of diverticular disease in primary care.},
journal = {The Nurse practitioner},
volume = {49},
number = {11},
pages = {29-30},
doi = {10.1097/01.NPR.0000000000000253},
pmid = {39467839},
issn = {1538-8662},
}

@article {pmid39467838,
year = {2024},
author = {Pateneaude, C and Lyden, C},
title = {Diagnosis and management of diverticular disease in primary care.},
journal = {The Nurse practitioner},
volume = {49},
number = {11},
pages = {23-29},
doi = {10.1097/01.NPR.0000000000000243},
pmid = {39467838},
issn = {1538-8662},
mesh = {Humans ; *Diverticular Diseases/diagnosis/therapy ; Primary Health Care ; Primary Care Nursing ; Nursing Diagnosis ; Nurse Practitioners ; Anti-Bacterial Agents/therapeutic use ; },
abstract = {Each year, more than 1 million ambulatory patient visits occur for diverticular disease, with nearly 75% of these patients seen in outpatient clinics. Although diverticulitis historically had been considered a disease of the older adult, it has become increasingly prevalent among the younger population. Likewise, in the past, antibiotics were considered first-line treatment for uncomplicated diverticulitis (Hinchey classification 0 and Ia); however, two large clinical trials compared treatment with antibiotics versus without antibiotics in uncomplicated cases of the disease and found no significant difference in patient outcomes. Based on these findings, first-line management now constitutes clear-liquid diet along with bowel rest for resolution of symptoms in these patients. Proper management with lifestyle modifications can help prevent complications and improve outcomes for patients with this condition; patient education is therefore critical.},
}

Humans
*Diverticular Diseases/diagnosis/therapy
Primary Health Care
Primary Care Nursing
Nursing Diagnosis
Nurse Practitioners
Anti-Bacterial Agents/therapeutic use

@article {pmid39466460,
year = {2024},
author = {Agnesi, S and Virgilio, F and Frontali, A and Zoni, G and Giugliano, M and Missaglia, C and Balla, A and Sileri, P and Vignali, A},
title = {Inferior mesenteric artery preservation techniques in the treatment of diverticular disease: a systematic review of the literature.},
journal = {International journal of colorectal disease},
volume = {39},
number = {1},
pages = {174},
pmid = {39466460},
issn = {1432-1262},
mesh = {Humans ; *Diverticular Diseases/surgery ; Laparoscopy/adverse effects ; Length of Stay ; *Mesenteric Artery, Inferior/surgery ; Operative Time ; Organ Sparing Treatments/adverse effects/methods ; Postoperative Complications/epidemiology/etiology ; Treatment Outcome ; },
abstract = {PURPOSE: The aim of this study is to analyze the impact of different surgical techniques used to preserve the inferior mesenteric artery on patient outcomes following left colonic resection.

METHODS: A search was conducted in PubMed, Embase and Web of Science, founding 4795 articles. The review was registered on PROSPERO (registration number: CRD42024572291).

RESULTS: Eleven articles published between 2001 and 2023, including 989 patients were the object of the present systematic review. Two hundred sixty-two patients (26.5%) underwent Valdoni's technique (Group A), which involves the skeletonization of the IMA, 272 (27.5%) underwent tubular resection (Group B), and 455 (46%) underwent peripheral dissection on sigmoid vessels (Group C). Laparoscopic surgery was predominant in Groups B (100%) and C (94.7%), while Group A had fewer laparoscopic procedures (44.6%). Patients in Group A experienced longer operative times (174.5 ± 27.4 min) and hospital stays (11.4 ± 3.6 days) compared to Groups B and C (165.9 min and 152.35 ± 46.9 min; 8.4 ± 5.7 days and 8.3 ± 3.6 days, respectively). Group A exhibited higher rates of anastomotic leakage (5%) compared to Group C (1.1%) and a higher incidence of bleeding (13%) compared to Group B (1.8%).

CONCLUSION: Valdoni's technique is less favourable for IMA preservation in left colon resection for diverticular disease. Peripheral dissection of sigmoid vessels or tubular resection is recommended for IMA preservation in this context.},
}

Humans
*Diverticular Diseases/surgery
Laparoscopy/adverse effects
Length of Stay
*Mesenteric Artery, Inferior/surgery
Operative Time
Organ Sparing Treatments/adverse effects/methods
Postoperative Complications/epidemiology/etiology
Treatment Outcome

@article {pmid39459415,
year = {2024},
author = {Alfaris, AM and Al Awaji, NN and Alabdulkarim, SA and Mallisho, AM and Hamdoun, AO and Bawazir, SM and AlAjroush, NA},
title = {Oral and Pharyngeal Diverticula: A Rare Case of Dysphagia and Diagnostic Challenges.},
journal = {Medicina (Kaunas, Lithuania)},
volume = {60},
number = {10},
pages = {},
pmid = {39459415},
issn = {1648-9144},
mesh = {Humans ; Male ; *Deglutition Disorders/etiology/diagnosis ; Middle Aged ; Diverticulum/complications/diagnosis/diagnostic imaging ; Saudi Arabia ; Fluoroscopy ; },
abstract = {This report describes the case of a 62-year-old male patient in Saudi Arabia who developed a diverticular pouch in his oral cavity. Diverticula are rare conditions that appear as protrusions or pouches within the digestive tract's inner lining. The condition can occur in different parts of the digestive system, but the colon is the most affected part. As part of the patient's symptoms, he presented with dysphagia, weight loss, and globus sensations. Multiple diagnostic tests, including ultrasound, computerized tomography (CT), and magnetic resonance imaging (MRI), did not identify the diverticula. Barium and upper gastrointestinal studies were the diagnostic tests that provided accurate diagnoses where several diverticula were discovered during the videofluoroscopic swallow study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES). Surgical intervention was recommended by the multidisciplinary team; however, the patient rejected this treatment option. This report highlights the necessity for instrumental swallowing diagnostic evaluation in the workup of the infrequent etiologies of dysphagia and suggests a gap in the current knowledge, prompting further studies on the etiology, incidence, and optimum management of upper gastrointestinal (GI) tract diverticular disease.},
}

Humans
Male
*Deglutition Disorders/etiology/diagnosis
Middle Aged
Diverticulum/complications/diagnosis/diagnostic imaging
Saudi Arabia
Fluoroscopy

@article {pmid39440345,
year = {2024},
author = {Huang, TH and Marker, M and Urdahl, T and Manivel, J and Rezcallah, AT},
title = {Mid-jejunal diverticulitis with closed-loop bowel obstruction, strangulation, and contained perforation.},
journal = {Clinical case reports},
volume = {12},
number = {10},
pages = {e9489},
pmid = {39440345},
issn = {2050-0904},
abstract = {KEY CLINICAL MESSAGE: Closed-loop bowel obstruction and contained perforation secondary to acute on chronic jejunal diverticulitis is rare and should be included in the differential diagnosis of acute abdomen. The association between polymyalgia rheumatica and diverticular disease requires further research but may prompt clinicians to consider appropriate therapies in patients with both diseases.

ABSTRACT: Jejunal diverticulosis is a sac-like outpouching of the intestinal wall that can cause complications such as diverticulitis, obstruction, abscess, perforation, or fistula formation. Complicated jejunal diverticulosis may present with acute abdomen and nonspecific symptoms which can lead to misdiagnosis and delayed treatment. A 76-year-old male with a remote history of polymyalgia rheumatica (PMR) presented with sudden onset abdominal pain, fever, nausea, vomiting, and inability to pass flatus. Physical exam revealed a distended and diffusely tender abdomen with signs of peritonitis. Laboratory test results were significant for neutrophil-dominant leukocytosis and elevated inflammatory markers. CT scan of the abdomen with IV contrast revealed a contained perforation and a closed-loop small bowel obstruction in the mid-abdomen. The patient underwent emergent exploratory laparotomy and resection of 100 cm of mid-jejunum which was found to have numerous diverticula surrounding the closed-loop obstruction and contained perforation. Pathology findings showed evidence of acute on chronic jejunal diverticulitis. Jejunal diverticulosis with complications may present with an acute abdomen and peritonitis. Closed-loop bowel obstruction and contained perforation secondary to acute on chronic jejunal diverticulitis is uncommonly thought of and should be considered in the differential diagnosis. Additionally, the association between PMR and diverticular disease is notable. While the patient had a remote history but no active PMR on presentation, studies suggest a possible association between gut inflammation and rheumatologic disease. This association should prompt clinicians to consider appropriate therapies and bear in mind the potential risk for diverticular perforation if glucocorticoids are given to treat PMR. Jejunal diverticulosis with multiple complications such as closed-loop bowel obstruction and contained perforation secondary to acute on chronic jejunal diverticulitis is rare and may present with an acute abdomen and nonspecific symptoms. Including rare pathologies as such in the differential diagnosis may prevent misdiagnosis and delayed treatment. While further investigation is needed, the association between diverticulosis and PMR is noteworthy as patients who present with both diseases would require mindful management due to the potential risk of diverticular perforation after treatment with steroids.},
}

@article {pmid39436838,
year = {2025},
author = {Gazzetta, J and Fesmire, A and Orjionwe, R and Benedict, LA and Nix, S},
title = {30-Day Readmissions and the Need for Emergency Surgery Following Non-Operative Management of Perforated Diverticulitis.},
journal = {Surgical infections},
volume = {26},
number = {1},
pages = {1-5},
doi = {10.1089/sur.2024.101},
pmid = {39436838},
issn = {1557-8674},
mesh = {Humans ; Male ; Female ; Retrospective Studies ; *Patient Readmission/statistics & numerical data ; Middle Aged ; *Intestinal Perforation/therapy/surgery ; Aged ; *Diverticulitis/therapy/complications ; Aged, 80 and over ; Adult ; Risk Factors ; },
abstract = {Background: Limited data are available on the evaluation and outcomes of patients with perforated diverticulitis who were treated without surgery. Aims: This retrospective review was aimed at investigating the 30-day non-elective re-admission rates for patients hospitalized with perforated diverticular disease who were treated without surgery, rates of patients requiring surgery on re-admission, and the independent predictors of re-admission. Methods: A total of 143,546 patients from the National Readmission Database, between 2016 and 2020, who were admitted with perforated diverticulitis and treated non-operatively were reviewed. Re-admitted patients were compared with those not re-admitted. Comparisons for continuous and categoric variables were made using the student t-test and chi-squared test, respectively. A logistic regression model was used to determine independent factors associated with re-admission. All analyses were done with SAS 9.4; p values <0.05 identified significance. Results: Among patients with perforated diverticulitis who were treated non-operatively, 17,868 (12.4%) were re-admitted within 30 days and 4,924 (27.6%) of patients re-admitted required surgical intervention. The greatest independent predictors of re-admission include patient insurance status, index length of stay, undergoing a drainage procedure, and patient disposition. Comorbidities predicting re-admission include renal failure, chronic pulmonary disease, diabetes mellitus, fluid and electrolyte disorders, and hypertension. Hospital total charges were greater at the index admission for patients requiring re-admission. Conclusion: Non-operative management of perforated diverticulitis is safe for many patients, but the risks for re-admission and subsequent need for emergency surgery require special consideration.},
}

Humans
Male
Female
Retrospective Studies
*Patient Readmission/statistics & numerical data
Middle Aged
*Intestinal Perforation/therapy/surgery
Aged
*Diverticulitis/therapy/complications
Aged, 80 and over
Adult
Risk Factors

@article {pmid39429357,
year = {2024},
author = {Ravichandran, KR and Munguia-Vazquez, R and Nirmalan, R},
title = {Spontaneous Colovesical Fistula With Benign Prostatic Hyperplasia and Prostatitis.},
journal = {Cureus},
volume = {16},
number = {9},
pages = {e69589},
pmid = {39429357},
issn = {2168-8184},
abstract = {We present an unusual case of colovesical fistula formed by a single diverticulum manifesting as prostatitis and urinary tract infection (UTI) before causing further complications. Diverticulitis is caused by inflammation of the colonic diverticula and manifests as fever and left lower quadrant pain. The patient also developed recurrent pneumaturia; upon examination, a colovesical fistula was observed on computed tomography (CT), which was managed successfully by laparoscopic repair. This case highlights manifestations of colovesical fistula secondary to diverticular disease and the laparoscopic approach to treatment.},
}

@article {pmid39429143,
year = {2024},
author = {Devlin, J and Reed, RN and Brody, F and Duncan, JE},
title = {Robotic Sigmoidectomy for Diverticular Disease.},
journal = {Journal of laparoendoscopic & advanced surgical techniques. Part A},
volume = {34},
number = {11},
pages = {967-971},
doi = {10.1089/lap.2024.0329},
pmid = {39429143},
issn = {1557-9034},
mesh = {Humans ; *Robotic Surgical Procedures/methods ; *Colon, Sigmoid/surgery ; *Colectomy/methods ; Diverticulitis, Colonic/surgery ; },
abstract = {Introduction: Historically, colon resection was recommended after one episode of complicated diverticulitis. However, current trends favor a more individualized approach. This review examines elective sigmoidectomy for complicated diverticulitis as well as robotic approaches for diverticular disease. Methods: The literature was reviewed for timely (post 2000) and relevant articles regarding robotics and diverticulitis. The articles included large prospective series, retrospective analysis, meta-analyses and randomized controlled trials. Results: Primary anastomosis with or without protective ileostomy has emerged as an alternative to the Hartman's procedure in emergent or urgent surgery in patients without significant comorbidities. Elective sigmoidectomy after an episode of complicated diverticulitis should be decided on a case-by-case basis considering patient characteristics, continued subacute symptoms, complications from the disease, and chance of recurrence episodes. Conclusions: There are several variations techniques for robotic sigmoidectomy outlined in this article, and familiarity with all can help depending on the logistics of the case. Minimally invasive colectomy provides superior patient satisfaction and outcomes.},
}

Humans
*Robotic Surgical Procedures/methods
*Colon, Sigmoid/surgery
*Colectomy/methods
Diverticulitis, Colonic/surgery

@article {pmid39409978,
year = {2024},
author = {Tondolo, V and Marzi, F and Amodio, LE and Rizzo, G},
title = {Short-Term Postoperative Outcomes after Resective Colorectal Surgery in Elderly vs. Nonelderly Patients: A Single Centre Retrospective Analysis.},
journal = {Cancers},
volume = {16},
number = {19},
pages = {},
pmid = {39409978},
issn = {2072-6694},
abstract = {Background/Objectives: Life expectancy for people in their 60s is 24.3 years in high-income countries. Health systems face the burden of disease in the elderly population and must assess the impact of treatments such as major surgery. The aim of this study is to quantify the impact of advanced age on short-term postoperative outcomes after resective colorectal surgery (RCRS). Methods: All patients who underwent RCRS at our institution between July 2022 and November 2023 were entered into a database. Preoperative, perioperative, and early (within 30 days) postoperative data were recorded. Patients were categorized into a young group (under 75 years, YG) and an elderly group (over 75 years, EG). A retrospective comparative analysis of postoperative outcomes was performed between the two groups; postoperative complications were graded according to the Clavien classification. Results: Fifty-three and ninety-five patients were in the EG and YG, respectively. Indications for RCRS was cancer in 83% of EG patients and 61.1% of YG patients (p = 0.006), and the clinical presentation, localization, and rate of neoadjuvant treatment in oncological patients were comparable. Another indication for RCRS was complicated diverticular disease (17% of EG patients and 38.9% of YG patients; p = 0.006). With respect to the baseline characteristics, the ASA and CCI scores were worse in the EG (p = 0.001). No significant differences in the surgical approach, mini-invasive approach, conversion rate, definitive stoma creation, or number of harvested lymph nodes were found between the two groups. Overall, EG reported a higher relative risk (RR) of short-term postoperative complications (1.64, CI: 1.03-2.63), but no significant differences were found in terms of grade ≥3 complications (RR: 0.9, CI: 0.23-3.44). In the EG, a higher risk of ICU admission (RR:2.69, CI: 1.5-4.8) and a one-day longer postoperative hospital stay (6 vs. 5 days) were reported. Conclusions: Advanced age does not seem to contraindicate RCRS, especially in colorectal cancer patients. The impact of elderly age on short-term outcomes seems to be minimal and acceptable.},
}

@article {pmid39407913,
year = {2024},
author = {Carletta, D and Popeskou, SG and Mongelli, F and Murgante, N and Di Giuseppe, M and Proietti, F and Hübner, M and Christoforidis, D},
title = {A Decade of Follow-Up to Assess the Risk of Recurrence and Surgery after a First Episode of Uncomplicated Left-Sided Diverticulitis.},
journal = {Journal of clinical medicine},
volume = {13},
number = {19},
pages = {},
pmid = {39407913},
issn = {2077-0383},
abstract = {Background and aims: Acute uncomplicated diverticulitis (UD) of the left colon is common and mostly benign. Due to controversy over the definition of UD and the lack of adequate follow-up in most studies, good quality data to predict long-term outcomes after a first episode of UD are missing. The aim of this study was to assess the long-term risk for adverse outcomes after a first episode of UD. Methods: All consecutive patients with a CT-scan-documented first episode of acute UD (staged "uncomplicated" according to ESCP guidelines and/or modified Hinchey stages 0-1a, and/or CDD 1-2a) between January 2010 and June 2013 were included in the study. CT scans and clinical records were retrospectively reviewed. The primary endpoint was overall recurrence; the secondary endpoint was surgery for diverticular disease. Results: One hundred and five patients were included in the study with a median follow-up of 116.4 (4.9-154.7) months. Of these, 51 (48.5%) patients had a recurrence, 11 (10.4%) had 4 or more episodes. Twenty-one (20%) patients underwent sigmoidectomy, all in an elective setting, mostly due to multiple recurrent episodes. Male gender was the only independent risk factor for surgery (OR (95%CI): 0.301 (0.109-0.834), p = 0.021). Classification systems did not predict recurrence, but stage CDD 1a was protective for surgery (OR (95%CI): 0.201 (0.042-0.957), p = 0.044). Conclusions: After a decade of follow-up, almost half the patients experienced at least one recurrent episode after UD, higher than previously thought. None of those patients required emergency surgery, but one in five patients, mostly men, underwent elective sigmoidectomy for multiple recurrent episodes.},
}

@article {pmid39404716,
year = {2024},
author = {Svistunov, AА and Osadchuk, MA and Mironova, ED and Krylova, IS},
title = {[Clinical, endoscopic, laboratory and immunomorphological parameters in predicting the occurrence of colorectal cancer in patients with diverticular disease of the colon].},
journal = {Terapevticheskii arkhiv},
volume = {96},
number = {8},
pages = {732-738},
doi = {10.26442/00403660.2024.08.202818},
pmid = {39404716},
issn = {0040-3660},
mesh = {Humans ; Male ; Female ; Middle Aged ; *Colorectal Neoplasms/pathology ; Tumor Suppressor Protein p53/metabolism ; Aged ; Colonoscopy/methods ; Ki-67 Antigen/analysis/metabolism ; Adult ; },
abstract = {AIM: To define the role of clinical, endoscopic, laboratory and immunomorphological parameters in predicting the occurrence and course of colorectal cancer (CRC) in patients with diverticular disease of the colon (DDC).

MATERIALS AND METHODS: One hundred and seventy five people with DDC were examined, divided into 3 groups: group 1 - 85 patients with DDC; group 2 - 45 with DDC in combination with adenomatous polyps (AP); 3rd group - 45 with DDC with established CRC (I or II stage). The control group consisted of 30 practically healthy people. Patients and healthy people were examined according to a single program: clinical, laboratory, instrumental data and immunomorphological research methods [use of primary antibodies to p53 (mAb clone DO-7 product no. PA0057, Leica Biosystems, Leica Bond III) and Ki-67 (Ab16667, Abcam, UK)].

RESULTS: Among the main complaints in patients with DDC and CRC, constipation was more common than in patients with DDC and DDC with AP (p<0.05). In patients with DDC and colorectal neoplasia, a positive reaction to occult blood in the feces was more often verified, compared with the group with DDC (p<0.05). Higher levels of glucose and cholesterol in blood plasma, as well as body mass index were found in patients with DDC with AP and CRC, compared with the DDC group (p<0.05). A higher level of expression of Ki-67 and p53 was found in patients with DDC combined with AP and CRC, compared with patients with DDC without colorectal neoplasia (p<0.05). At the same time, in patients with DDC with CRC, the expression level of Ki-67 and p53 was higher than in patients with DDC with AP (p<0.05) Conclusion. In patients with DDC combined with AP and CRC, higher levels of glucose, plasma cholesterol, as well as body mass index were observed compared to the group of patients with DDC alone (p<0.05). Of note, the results of the determination of Ki-67 and p53 in the mucous membrane of the colon should be considered important prognostic markers for the development of CRC in patients with DDC.},
}

Humans
Male
Female
Middle Aged
*Colorectal Neoplasms/pathology
Tumor Suppressor Protein p53/metabolism
Aged
Colonoscopy/methods
Ki-67 Antigen/analysis/metabolism
Adult

@article {pmid39400547,
year = {2025},
author = {Zhan, D and Yang, Z and Li, P and Pan, J},
title = {Therapeutic targets for gastrointestinal diseases: proteome-wide Mendelian randomization and colocalization analyses.},
journal = {Postgraduate medical journal},
volume = {101},
number = {1194},
pages = {283-290},
doi = {10.1093/postmj/qgae140},
pmid = {39400547},
issn = {1469-0756},
mesh = {Humans ; Mendelian Randomization Analysis ; *Proteome ; *Gastrointestinal Diseases/genetics/blood ; Crohn Disease/genetics/blood ; *Blood Proteins/genetics ; Genetic Predisposition to Disease ; Colitis, Ulcerative/genetics/blood ; },
abstract = {PURPOSE: This study was aimed to identify serum proteins linked with gastrointestinal diseases by proteome-wide Mendelian randomization analysis.

METHODS: We determined the casual relationship between 732 kinds of circulating proteins and the 24 kinds of gastrointestinal diseases via Mendelian randomization analysis.

RESULTS: Four circulating proteins (FCGR3B, IL-12B, MAPKAPK2, and IL-23R) were associated with the occurrence of ulcerative colitis (UC), and IL23R was also correlated with risk of Crohn's disease (CD). Genetically predicted levels of IL23R were strongly correlated with the risk of UC and CD based on the high supporting evidence of colocalization analysis. Five circulating proteins (NOV, EFEMP1, ADGRE2, LCT, and SEMA3G) were associated with the risk of diverticulosis disease. With high supporting evidence of colocalization, genetically predicted levels of NOV and SEMA3G were inversely correlated with the risk of diverticulosis disease. Five circulating proteins (FUT3, FUT5, CRHBP, SULT2A1, and QPCTL) were associated with the occurrence of cholelithiasis. With high supporting evidence of colocalization, genetically predicted levels of FUT3 and CRHBP were inversely correlated with the risk of cholelithiasis.

CONCLUSIONS: The proteome-wide Mendelian randomization investigation identified several circulating proteins associated with the risk of UC, CD, diverticular disease and cholelithiasis, which reinforced the understanding of molecular pathogenesis and design of therapeutic targets.},
}

Humans
Mendelian Randomization Analysis
*Proteome
*Gastrointestinal Diseases/genetics/blood
Crohn Disease/genetics/blood
*Blood Proteins/genetics
Genetic Predisposition to Disease
Colitis, Ulcerative/genetics/blood

@article {pmid39399131,
year = {2024},
author = {Wu, S and Al Khaldi, M and Richard, CS and Dagbert, F},
title = {Diverticulitis: A Review of Current and Emerging Practice-Changing Evidence.},
journal = {Clinics in colon and rectal surgery},
volume = {37},
number = {6},
pages = {359-367},
pmid = {39399131},
issn = {1531-0043},
abstract = {Acute diverticulitis represents a common colorectal emergency seen in the Western world. Over time, management of this condition has evolved. This review aims to highlight recent evidence and update current recommendations. Notable evidence has emerged in certain aspects of diverticulitis. This includes disease pathogenesis, as emerging data suggest a potentially greater role for the microbiome and genetic predisposition than previously thought. Acute management has also seen major shifts, where traditional antibiotic treatment may no longer be necessary for acute uncomplicated diverticulitis. Following successful medical management of acute diverticulitis, indications for elective sigmoidectomy have decreased. The benefit of emergency surgery remains for peritonitis, sepsis, obstruction, and acute diverticulitis in certain immunocompromised patients. Routine colonoscopy, once recommended after all acute diverticulitis episodes, has been shown to be beneficial for cancer exclusion in a distinct patient population. Despite advances in research, certain entities remain poorly understood, such as smoldering diverticulitis and symptomatic uncomplicated diverticular disease. As research in the field expands, paradigm shifts will shape our understanding of diverticulitis, influencing how clinicians approach management and educate patients.},
}

@article {pmid39391124,
year = {2024},
author = {Romero, AL and Romero, J and Sah, A and Koomson, A and Arun, N},
title = {Acute Transverse Colon Diverticulitis: A Case Report and Literature Review.},
journal = {Journal of community hospital internal medicine perspectives},
volume = {14},
number = {4},
pages = {105-110},
pmid = {39391124},
issn = {2000-9666},
abstract = {Diverticular disease is a condition that ranges from asymptomatic disease to severe complications, such as abscesses, fistulas, and perforations. It is prevalent in Western countries, with up to 60% of people aged 60 having diverticula. In Asian countries, the prevalence is lower, ranging from 13 to 25%. Diverticulitis can occur in any location of the diverticula, with increasing incidence with age. Complications occur in 12% of patients with diverticulitis, with phlegmon or abscesses being the most common. Perforation is a life-threatening complication with a 1-year mortality rate of 20%. Recent studies suggest that chronic inflammation and alteration of the gut microbiome may play a role in diverticulitis, leading to a less aggressive and conservative approach to treatment. Even though diverticular disease represents a very common clinical entity, diverticula located in the transverse colon it is an extremely rare presentation. We present the case of a 39-year-old female with a history of multiple medical conditions who presented to the Emergency Room (ER) with severe diffuse abdominal pain predominantly in the right lower quadrant associated with shortness of breath. Upon physical examination, she was found to have severe pain, bilateral rhonchi, and a diffusely tender abdomen with guarding without rebound tenderness. Lab analysis showed leukocytosis, and a CT scan of the abdomen and pelvis revealed acute transverse diverticulitis which was treated medically.},
}

@article {pmid39381446,
year = {2024},
author = {Tapias, E and Rivera, EF and Finlayson, B and Rowe, DA and Mateja, HL and Umbu, LK and DeVito, PM},
title = {Perforated Jejunal Diverticulum Mimicking Diverticulitis: A Case Report of Acute Abdominal Pain in an Elderly Patient.},
journal = {Cureus},
volume = {16},
number = {9},
pages = {e68935},
pmid = {39381446},
issn = {2168-8184},
abstract = {Jejunal diverticulosis is a rare form of diverticulosis characterized by acquired pseudodiverticula in the small bowel. Although most cases are asymptomatic, the condition can present diagnostic challenges due to its atypical presentation. Complications such as perforation can lead to acute abdomen, significantly increasing morbidity and mortality. We report a rare case of perforated jejunal diverticulitis in an 84-year-old female with a known history of diverticular disease. The patient presented to the emergency department with worsening left lower quadrant abdominal pain. A computed tomography (CT) scan revealed a focus of air adjacent to the mesentery, indicative of bowel perforation. An urgent exploratory laparotomy was performed, which identified a 4-cm perforated jejunal diverticulum. The affected segment of the small bowel was resected, followed by primary side-to-side jejunal anastomosis. The patient was discharged home in stable condition following uneventful postoperative recovery. This case highlights the importance of including jejunal diverticulosis in the differential diagnosis of acute abdomen, particularly in elderly patients with a history of diverticular disease. Due to the nonspecific presentation, prompt imaging is crucial for diagnosis. Surgical intervention is often necessary in cases of perforation. Increased clinical awareness of this rare condition may help reduce diagnostic delays and improve patient outcomes.},
}

@article {pmid39361072,
year = {2024},
author = {McClelland, PH and Liu, T and Johnson, RP and Glenn, C and Ozuner, G},
title = {Iatrogenic urinary injuries in colorectal surgery: outcomes and risk factors from a nationwide cohort.},
journal = {Techniques in coloproctology},
volume = {28},
number = {1},
pages = {137},
pmid = {39361072},
issn = {1128-045X},
mesh = {Humans ; *Iatrogenic Disease ; Male ; Female ; Risk Factors ; Middle Aged ; *Postoperative Complications/etiology/epidemiology ; Aged ; Databases, Factual ; Colorectal Surgery/adverse effects ; Adult ; Laparoscopy/adverse effects/statistics & numerical data ; Urinary Tract/injuries ; Retrospective Studies ; United States/epidemiology ; Cohort Studies ; },
abstract = {BACKGROUND: Iatrogenic urinary injury (IUI) can lead to significant complications after colorectal surgery, especially when diagnosis is delayed. This study analyzes risk factors associated with IUI and delayed IUI among patients undergoing colorectal procedures.

METHODS: Adults undergoing colorectal surgery between 2012 and 2021 were identified in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP[®]) database. Multivariable regression analysis was used to determine risk factors and outcomes associated with IUI and delayed IUI.

RESULTS: Among 566,036 patients, 5836 patients (1.0%) had IUI after colorectal surgery, of whom 236 (4.0%) had delayed IUI. Multiple preoperative risk factors for IUI and delayed IUI were identified, with disseminated cancer [adjusted odds ratio (aOR) 1.4, 95% confidence interval (CI) 1.2-1.5; p < 0.001] and diverticular disease [aOR 1.1, 95% CI 1.0-1.2; p = 0.009] correlated with IUI and increased body mass index [aOR 1.6, 95% CI 1.2-2.1; p = 0.003] and ascites [aOR 5.6, 95% CI 2.1-15.4; p = 0.001] associated with delayed IUI. Laparoscopic approach was associated with decreased risk of IUI [aOR 0.4, 95% CI 0.4-0.5; p < 0.001] and increased risk of delayed IUI [aOR 1.8, 95% CI 1.4-2.5; p < 0.001]. Both IUI and delayed IUI were associated with significant postoperative morbidity, with severe multiorgan complications seen in delayed IUI.

CONCLUSIONS: While IUI occurs infrequently in colorectal surgery, unrecognized injuries can complicate repair and cause other negative postoperative outcomes. Patients with complex intra-abdominal pathology are at increased risk of IUI, and patients with large body habitus undergoing laparoscopic procedures are at increased risk of delayed IUI.},
}

Humans
*Iatrogenic Disease
Male
Female
Risk Factors
Middle Aged
*Postoperative Complications/etiology/epidemiology
Aged
Databases, Factual
Colorectal Surgery/adverse effects
Adult
Laparoscopy/adverse effects/statistics & numerical data
Urinary Tract/injuries
Retrospective Studies
United States/epidemiology
Cohort Studies

@article {pmid39360292,
year = {2024},
author = {Wang, K and Wang, S and Chen, X},
title = {The Causal Effects between Mood Swings and Gastrointestinal Diseases: A Mendelian Randomization Study.},
journal = {Alpha psychiatry},
volume = {25},
number = {4},
pages = {533-540},
pmid = {39360292},
issn = {2757-8038},
abstract = {BACKGROUND: Numerous studies have examined the links between mental disorders such as depression and bipolar disorder, and gastrointestinal (GI) diseases. However, few studies have investigated the link between mood swings and GI diseases. Given the impact of mood swings on various conditions and the growing comprehension of the gut-brain axis, this study aims to explore their causal relationship using Mendelian randomization (MR) methods.

METHODS: Single-nucleotide polymorphisms (SNPs) associated with mood swings were obtained from a recent study. SNPs associated with GI diseases were identified from the FinnGen project. We conducted two-sample bidirectional MR analyses using three methods, primarily the inverse variance weighting (IVW) method. Furthermore, we performed sensitivity analyses and false discovery rate (FDR) analysis to validate the accuracy and robustness of the results.

RESULTS: Bidirectional MR analysis revealed significant causal effects between mood swings and GI diseases according to the IVW method (odds ratio (OR): 1.213; 95% confidence interval (CI): 1.118-1.316; P = 3.490e-6; P FDR = 8.730e-5). Mood swings were linked to an increased risk for 11 of 24 diseases, including five upper GI diseases (gastroesophageal reflux disease (GERD), acute gastritis, gastroduodenal ulcer, duodenal ulcer, and functional dyspepsia), two lower GI diseases (diverticular disease of the intestine and irritable bowel syndrome (IBS)) and four hepatobiliary and pancreatic diseases (nonalcoholic fatty liver disease (NAFLD), chronic pancreatitis, acute pancreatitis, and pancreatic cancer). Inverse MR analysis showed no causal relationship between 24 GI diseases and mood swings.

CONCLUSIONS: This comprehensive MR analysis suggests that genetically predicted mood swings may be a risk factor in the development of GI diseases. Interventions for mood swings may help to treat GI diseases.},
}

@article {pmid39360096,
year = {2024},
author = {Naraynsingh, V and Maharaj, M and Rampersad, FS and Hassranah, SC and Maharajh, S},
title = {Are We Resecting Too Much Colon in Perforated Diverticulitis?.},
journal = {Cureus},
volume = {16},
number = {9},
pages = {e68473},
pmid = {39360096},
issn = {2168-8184},
abstract = {Initially, the Hartmann's procedure was done to reduce mortality in surgery cases of malignant rectal lesions, and not benign disease. However, the procedure was popularized in the management of perforated diverticular disease (PDD) in the 1970s. Herein, we present a case of a patient who had laparotomy and colostomy for PDD. During the post-operative planning for reversal of the diverting colostomy, a contrast study was done that revealed that most of the sigmoid colon was in fact healthy. In this patient, the colon was severed at the point of the perforation and exteriorized, which allowed time for the resolution of the gut inflammatory changes. Thus, Hartmann's operation would have led to the unnecessary resection of the healthy sigmoid colon and possibly condemned the patient to an irreversible stoma. In severe PDD, where a Hartmann's procedure is considered, one could sever the colon at the site of perforation and bring out a colostomy while tacking the closed, unresected distal end near the ostomy. Further contrast studies of the colon could assist in planning resection and anastomosis.},
}