Ileocaecal intussusception of a previously recognized Meckel's diverticulum

A case is reported of an ileocaecal intussusception caused by a previously recognized Meckel's diverticulum. The case offers the opportunity to discuss the management of an asymptomatic Meckel's diverticulum found incidentally. The conclusion is reached that, in general, diverticulectomy is appropriate.     

Spontaneous Perforation of Meckel's Diverticulum Without Peritonitis in a Newborn: Report of a Case

A case of a newborn male with a perforation of Meckel's diverticulum is reported. The clinical course consisted of progressive abdominal distention and pneumoperitoneum that formed within 29 h after birth. The perforation of Meckel's diverticulum was not associated with peritonitis because meconium did not contaminate the abdominal cavity. The histology of the diverticulum showed a nearly intact muscular layer but a focal muscular defect. Neither any inflammatory phenomena nor ectopic mucosa was found. A congenital focal muscular defect of the diverticulum and a sudden elevation of intraluminal pressure due to bowel movement after birth may thus be the pathogenesis of a spontaneous perforation. A search of the English literature did not reveal any similar case.     

Anterior Urethral Diverticulum Produced by Cowper's Gland Duct Cyst

A case of congenital urethral diverticulum is presented. The patient was a 16-year-old boy with the chief complaint of dribbling urine since he was 14 years old. A retrograde urethrogram revealed a diverticulum of the bulbar urethra, which had been produced by a cystic dilation of the Cowper's gland duct. The walls of the diverticulum were resected endoscopically.     

Subacute intestinal obstruction caused by giant bladder diverticulum

A case of a patient affected with intestinal obstruction of 4 days of evolution is presented. The diagnosis of giant bladder diverticulum due to Benign Prostatic Hypertrophy was made by abdominal ultrasound at Emergency Room, and afterwards was confirmed by cystography. A trabeculated wall and a diverticulum at the posterior side was seen with the cystography. The diverticulum full of urine couldn't be emptied due to a narrow diverticular neck and the rectum was obstructed. When a urethral catheter was put in, the symptoms of intestinal obstruction disappeared 800 ml of urine were passed through the catheter and the rectum compression was released; the gas was allowed to pass through the bowel and it's seen in plain X-Ray. This case is presented, considering its unusual this way of presentation of a giant bladder diverticulum. We have reviewed the literature en Medline since 1966 and we have not found a similar case.     

Diverticulum of the lateral ventricle causing cerebellar ataxia. Case report

A case of ventricular diverticulum causing cerebellar ataxia is presented. Computerized tomography clearly demonstrated the aperture of the diverticulum in the medial wall of the trigone and its extension into the posterior fossa. The diverticulum regressed and the cerebellar ataxia disappeared after placement of a ventriculoperitoneal shunt.     

Urethral diverticulum with endometriosis.

A case of urethral diverticulum in a female patient with endometriosis in the diverticular wall is presented. Review of the recent urologic literature reveals no such case reported previously. The diverticulum was excised and the urethral walls were approximated, with uneventful postoperative recovery.     

Dysphagia due to aortic diverticulum: an adult surgical case.

A right aortic arch is an anatomic variant only occurring in approximately 0.1% of the population. A mirror-image right artic arch without congenital cardiac anomaly is fairly uncommon. We report on a rare case of dysphagia due to isolated aortic diverticulum in a mirror-image right aortic arch. A 72-year-old man presented with dysphagia which was due to posterior compression of the esophagus by a dilated aortic diverticulum. There was no vascular ring and we thought that the pathology was atherosclerotic dilatation of the diverticulum. Graft replacement of the diverticulum was sufficient to relieve his symptom.     

Thoracoscopic resection of a giant midesophageal diverticulum

A giant midesophageal true diverticulum is a medical rarity. We report a case of successful minimally invasive resection of a giant midesophageal diverticulum masquerading as a malignancy in a young patient.     

Case report: congenital ureteral diverticulum and solitary kidney.

A case of true congenital diverticulum of the ureter associated with a solitary kidney is reported. The diverticulum was producing hydroureteronephrosis. Treatment consisted of excision of the diverticulum and repair of the narrowed area in the ureter. At 4-year followup there was no deterioration on excretory urography and renal function tests have remained normal.     

Zenker's diverticulum associated with multilevel cervical osteomyelitis

STUDY DESIGN: A case report of cervical osteomyelitis possibly associated with a Zenker's diverticulum perforation. OBJECTIVES: To present clinical, radiologic, and surgical findings of a cervical osteomyelitis due to a Zenker's diverticulum perforation. SUMMARY OF BACKGROUND DATA: A 56-year-old patient was in an intensive care unit for a severe head injury. He was fed via a nasogastric tube. Four months later he developed a pyogenic cervical vertebral infection. METHODS: Plain films and magnetic resonance imaging showed a diffuse cervical osteomyelitis. Investigation of his dysphagia revealed a Zenker's diverticulum. RESULTS: After administration of antibiotics and surgical treatment of the diverticulum, the cervical infection resolved. Plain films and magnetic resonance imaging showed healing with vertebral fusion. CONCLUSIONS: Cervical osteomyelitis is uncommon. Only one case of direct contamination leading to cervical vertebral osteomyelitis after esophageal perforation has been previously described. Direct contamination of the prevertebral soft tissues by bacteria traveling through the fistula may have occurred. The development of vertebral osteomyelitis in this case is consistent with the hypothesis of direct contamination. Management relies on appropriate antimicrobial therapy and surgical management of the diverticulum. The association of Zenker's diverticulum with vertebral osteomyelitis and discitis is a unique, previously undescribed situation.     

Giant urethral diverticulum after free full thickness skin graft urethroplasty.

A case of a giant urethral diverticulum, developing as a complication of a free skin graft urethroplasty 2 years previously, is reported. The incidence of diverticulum formation in reported series of free skin graft urethroplasty is small. The degree of dilatation present in this case has not been reported in the recent literature and its management is discussed.     

Meckel's diverticulum in laparoscopic era

A recent case of a Meckel's diverticulum diagnosed and successfully laparoscopically treated, triggered off a retrospective study on a series of 34 cases with Meckel's diverticulum admitted to the First Surgical Clinic between 1990-2003. We encountered 12 uncomplicated cases and 22 cases with a large panel of complications: 11 intestinal obstructions (volvulus 9, intussusceptions on a tumor-2), 9 cases with diverticulitis, 1 gastrointestinal bleeding and 1 case with Littre's inguinal hernia. Positive diagnosis was established intraoperatively and the surgical treatment was adapted according to the local situation (excision of the diverticulum or enterectomy). Out of 12 patients with uncomplicated Meckel's diverticulum 8 were subjected to prophylactic excision of the diverticulum. In 6 of these microscopic examinations were inclusions of gastric mucosa. Laparoscopy is safe, relatively inexpensive and efficient in the diagnosis and treatment of Meckel's diverticulum.     

Atresia of the foramen of Monro resulting in severe unilateral hydrocephalus with subfalcial herniation and infratentorial diverticulum

A case of severe unilateral hydrocephalus associated with ventricular diverticulum and subfalcial herniation secondary to likely atresia of the foramen of Monro is presented. Both atresia of the foramen of Monro and ventricular diverticulum are rare conditions in hydrocephalus. The case presented here is the third reported case with both unique entities.     

Restoration of continence using TUR (author's transl)]

A case of incontinence and diverticulum of urethra produced by TUR is demonstrated. By turning the diverticulum inside the urethra continence could be restored.     

Killian-Jamieson diverticulitis with cervical cellulitis: Report of a case

A Killian-Jamieson (K-J) diverticulum is an uncommon hypopharyngeal diverticulum related to the better-recognized Zenker’s diverticulum. Cervical cellulitis due to K-J diverticulitis is also highly exceptional. We report the case of a 53-year-old woman with cervical cellulitis caused by K-J diverticulitis. The cellulitis was cured by the administration of an antibiotic agent. The patient underwent a resection of the K-J diverticulum 2 months after the cellulitis was cured. The cervical diverticulum was judged to be a K-J diverticulum because the diverticulum prolapsed laterally just below the cricopharyngeus muscle on the esophagogram. The left recurrent laryngeal nerve adhered to the proximity of the orifice of the diverticulum. The recurrent laryngeal nerve was carefully preserved before the resection of the diverticulum. Accurate differential diagnosis between K-J and Zenker’s diverticula is necessary before surgery to preserve the recurrent laryngeal nerve.     

Large Vesical Diverticulae with Narrow Neck, Presenting with Features of Severe Urinary Tract Infection Managed Surgically

A case of multiple large urinary bladder diverticulae, with narrow neck, presented with features of severe urinary tract infection, with increased frequency of micturition, not treated since a long time. The muscular dehiscence that is at the origin of a diverticulum may be either congenital or degenerative. Two important complications of the diverticulum—that are sometimes interwoven—may occur: a draining defect and the development of an urothelial tumour in the diverticulum cavity. For such complicated diverticula, surgery is indicated. Results may be excellent, provided the surgical intervention focuses at the same time on the management of the associated subvesical obstacle in case of an acquired diverticulum.     

A case of nephrogenic adenoma in the female urethral diverticulum

A case of nephrogenic adenoma in the female urethral diverticulum is reported. A 39-year-old woman visited our hospital with the chief complaint of perineal pain. Observation of her perineum and transvaginal digital examination revealed urethral diverticulum, and then diverticulectomy was performed. Histological diagnosis was urethral diverticulum associated with nephrogenic adenoma. In Japan, this is the 1st report of nephrogenic adenoma arising in the female urethral diverticulum. We reviewed 305 cases of nephrogenic adenoma of the urinary tract in the English and Japanese literature.     

A case of small cell carcinoma in a diverticulum of the bladder

We report a case of small cell carcinoma in a diverticulum of the bladder. A 64-year-old Japanese man visited our hospital with the chief complaint of urinary retention. Cystoscopy revealed a papillary tumor arising in a diverticulum on the right lateral wall of the bladder. Partial cystectomy was performed under the diagnosis of bladder cancer in the diverticulum. The histopathological diagnosis was a combination of small cell carcinoma and urothelial carcinoma, of which the former was dominant. It is often difficult to detect tumors in the bladder diverticula and its early penetration is not rare because of the thin wall. Therefore, the prognosis of the bladder cancer in the diverticulum is believed to be generally poor. On the other hand, small cell carcinoma originating in the urinary bladder is also characterized by its extreme rareness and poor prognosis. To our knowledge, this is the second case report of the small cell carcinoma arising in a diverticulum of the urinary bladder in the Japanese literature.     

Surgical repair of a coronary sinus diverticulum not associated with Wolff-Parkinson-White syndrome

Diverticulum of the coronary sinus is rare. A 58-year-old man without Wolff-Parkinson-White syndrome underwent repair of a coronary sinus diverticulum accompanies by mitral regurgitation. The coronary sinus diverticulum had been identified 6 years earlier and had enlarged over time. At surgery, the neck of the diverticulum was closed, and the mitral valve replaced with a CarboMedics prosthetic valve (diameter, 29 mm). This the first case report of the surgical repair of a coronary sinus diverticulum not associated with Wolff-Parkinson-White syndrome.