RESUMO
ABSTRACT Introduction: The urinary bladder diverticula (BD) secondary to benign prostatic hyperplasia (BPH) is a complication that can lead to urinary stasis, stone, urinary tract infection (UTI) and tumors. It's role in acute urinary retention (AUR) is not totally understood. Objectives: To determine the effect of BD size on AUR rates in patients with BPH candidates to surgery. Subjects and Methods: We performed a retrospective cohort study of 47 patients with BPH and BD who underwent BPH surgery associated to complete bladder diverticulectomy from 2006 to 2016. We analyzed risk factors for AUR in patients with BD using univariate, multivariate and correlation analysis. Results: There was a difference in the size of the diverticula, with 6.8 cm vs. 4.5 cm among patients with and without AUR respectively (p=0.005). The ROC curve showed a correlation between the size of BD and the risk of AUR. The value of 5.15 cm presented a sensitivity of 73% and a specificity of 72%. The area under the curve was 0.75 (p=0.01). Comparing groups with BD >5.0 cm vs. ≤5.0 cm, the AUR incidence was 74% and 27.8% respectively with an OR of 2.65 (1.20-5.85) (p=0.005). In the multivariate analysis, only the size of the diverticula reached statistical significance (p=0.012). Conclusions: The diameter of BD is an independent risk factor for AUR in patients with BPH and BD who are candidates to surgery. A diameter greater than 5.15 cm increases the risk of AUR.
Assuntos
Humanos , Masculino , Idoso , Hiperplasia Prostática/cirurgia , Hiperplasia Prostática/complicações , Bexiga Urinária/anormalidades , Retenção Urinária/etiologia , Divertículo/complicações , Divertículo/patologia , Valores de Referência , Bexiga Urinária/patologia , Bexiga Urinária/diagnóstico por imagem , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Doença Aguda , Estudos Retrospectivos , Fatores de Risco , Curva ROC , Divertículo/diagnóstico por imagem , Medição de Risco , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: The urinary bladder diverticula (BD) secondary to benign prostatic hyperplasia (BPH) is a complication that can lead to urinary stasis, stone, urinary tract infection (UTI) and tumors. It's role in acute urinary retention (AUR) is not totally understood. OBJECTIVES: To determine the effect of BD size on AUR rates in patients with BPH candidates to surgery. SUBJECTS AND METHODS: We performed a retrospective cohort study of 47 patients with BPH and BD who underwent BPH surgery associated to complete bladder diverticulectomy from 2006 to 2016. We analyzed risk factors for AUR in patients with BD using univariate, multivariate and correlation analysis. RESULTS: There was a difference in the size of the diverticula, with 6.8 cm vs. 4.5 cm among patients with and without AUR respectively (p=0.005). The ROC curve showed a correlation between the size of BD and the risk of AUR. The value of 5.15 cm presented a sensitivity of 73% and a specificity of 72%. The area under the curve was 0.75 (p=0.01). Comparing groups with BD >5.0 cm vs. ≤5.0 cm, the AUR incidence was 74% and 27.8% respectively with an OR of 2.65 (1.20-5.85) (p=0.005). In the multivariate analysis, only the size of the diverticula reached statistical significance (p=0.012). CONCLUSIONS: The diameter of BD is an independent risk factor for AUR in patients with BPH and BD who are candidates to surgery. A diameter greater than 5.15 cm increases the risk of AUR.
Assuntos
Divertículo/complicações , Divertículo/patologia , Hiperplasia Prostática/complicações , Hiperplasia Prostática/cirurgia , Bexiga Urinária/anormalidades , Retenção Urinária/etiologia , Doença Aguda , Idoso , Divertículo/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/patologiaAssuntos
Divertículo/patologia , Ventrículos do Coração/patologia , Septo Interventricular/patologia , Adulto , Divertículo/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Ultrassonografia , Septo Interventricular/diagnóstico por imagemRESUMO
Urachal anomalies are infrequent, especially in adult patients, nevertheless their presentation must be well known. We present two cases with complicated urachal anomalies: a vesicourachal diverticulum and a urachal cyst. We will discuss their embriologic and anatomic characteristics, as well as their complications.
Las anomalías uracales son poco frecuentes especialmente en adultos, sin embargo, su forma de manifestarse debe conocerse. Presentamos dos casos de anomalías uracales complicadas: un divertículo y un quiste uracal. Se discuten las características embriológicas, ana-tómicas y complicaciones.
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Divertículo/patologia , Divertículo , Cisto do Úraco/patologia , Cisto do Úraco , Diagnóstico DiferencialRESUMO
Urinary retention due to bladder diverticulum is a rare clinical entity. We report Three males that were subjected to transurethral resection of prostate due benign hyperplasia with urinary retention, after removal of the catheter during postoperative period, requiring a new catheterization, and an adolescent woman with history of urinary infection that presented urinary retention four previous months to her first interview in the service. The later investigation demonstrated in all patients a big bladder diverticulum. The diverticulectomy reestablished the satisfactory bladder emptying in all patients. The origin of the bladder diverticula, the mechanism of the urinary retention without obstruction and its treatment is discussed.
Assuntos
Divertículo/complicações , Doenças da Bexiga Urinária/complicações , Retenção Urinária/etiologia , Doença Aguda , Adolescente , Divertículo/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Bexiga Urinária/patologiaRESUMO
Jejunal diverticulosis is a very uncommon acquired disease. Clinical manifestations include acute life threatening complication such as perforation, obstruction and bleeding. Jejunal diverticulosis is an extremely rare site of origin of gastrointestinal bleeding, with fewer than seventy cases reported in the literature. We report a 77-year -old patient with a recurrent severe gastrointestinal bleeding manifested by melena and hematochaezia. During the hospitalization the tagged red blood cell scanning was positive for bleeding in the jejunum. At laparotomy, several large-mouthed diverticula at the proximal jejunum were identified. Approximately 30 centimeters of the involved segment was resected with primary end-to-end anastomosis. Postoperative 7 month evolution has been favorable, without any evidence of rebleeding. This report reviews the literature concerning this disease, discusses some diagnostic methods of studying small bowel bleeding and highlights the need to consider this diagnosis in old patients with a gastrointestinal hemorrhage of unknown origin
Assuntos
Humanos , Masculino , Idoso , Hemorragia Gastrointestinal/etiologia , Doenças do Jejuno/complicações , Divertículo/complicações , Hemorragia Gastrointestinal/cirurgia , Hemorragia Gastrointestinal/diagnóstico , Jejuno/patologia , Doenças do Jejuno , Diagnóstico Diferencial , Divertículo , Divertículo/patologiaRESUMO
Jejunal diverticulosis is a rare and often asymptomatic disease, generally presenting as an occasional finding during laparotomy for other diseases. There are no established criteria for the treatment of such diverticula. Due to the possible onset of acute complications, surgical management must be considered. Personal experience on a case of jejunal diverticulosis in a woman who presented with acute complications of surgical peritoneal adhesions is described. Through examinations of small intestine discovered many diverticula, mainly in the mesenteric side; two diverticula were particularly large. Even though there appeared to be no symptoms due to the diverticula, major diverticula were considered at risk for acute complications. Because their reduction was not easily achievable, they were resected and enterotomies were stitched. Postoperative course was uneventful and after 2 years the patient is alive and well. Features of this rare entity are analyzed with regard to data reported in the literature, with special reference to some pathogenetic theories.
Assuntos
Divertículo/patologia , Doenças do Jejuno/patologia , Divertículo/cirurgia , Feminino , Humanos , Doenças do Jejuno/cirurgia , Pessoa de Meia-IdadeRESUMO
After a long symptom period of 19 years a submucosal tumor was suspected on endoscopy to account for the patient's intermittent nausea and abdominal pain. Duodenal waterfilling during endoscopic ultrasound led to the endosonographic diagnosis of an intraluminal duodenal diverticulum which was removed surgically. The patient became completely asymptomatic.
Assuntos
Divertículo/diagnóstico por imagem , Duodenopatias/diagnóstico por imagem , Endossonografia , Adulto , Diagnóstico Diferencial , Divertículo/patologia , Divertículo/cirurgia , Duodenopatias/patologia , Duodenopatias/cirurgia , Duodeno/diagnóstico por imagem , Duodeno/patologia , Duodeno/cirurgia , Humanos , MasculinoRESUMO
O diverticulo duodenal e uma anormalidade anatomica comum. Sua perfuracao decorrente de processo inflamatorio e bastante rara, com menos de 100 relatos na literatura consultada. Mais rara ainda e a perfuracao traumatica, representada apenas por tres casos relatados. Os autores relatam um caso de ruptura traumatica de diverticulo duodenal, e fazem uma revisao da literatura, focalizando a patogenia, o diagnostico e a terapeutica desta grave patologia
Assuntos
Humanos , Masculino , Adulto , Divertículo/patologia , Duodeno/lesões , RupturaRESUMO
The ileal protrusion into the lumen of the large intestine was studied in 9 patients (8 adults and 1 girl), 6 females and 3 males, all Brazilians and Caucasians. One of the patients resulted to have no disease, whereas in the others was confirmed the suspected diverticulosis, non specific ulcerative colitis, polyposis, regional ileitis or tuberculosis. In all cases the papillary and bilabial types of the termination of the ileum was documented by endoscopic photography, justifying the change of the expression "Bauhin's ileocecal valve" to that of "eminentia ilealis". Even in cases (one with regional ileitis and the other with tuberculosis) in which the disease altered the eminentia ilealis, it was possible to recognize the ileal papilla. Endoscopy confirmed direct, in vivo observations of ileal papilla, excluding the influence of the surgical procedure (incision and exteriorization in cases of cecostomy) in the morphological aspect of the normal eminentia ilealis.
Assuntos
Colite Ulcerativa/patologia , Doença de Crohn/patologia , Divertículo/patologia , Íleo/citologia , Íleo/patologia , Adulto , Brasil , Criança , Colonoscopia/métodos , Feminino , Humanos , Masculino , Valores de Referência , População BrancaRESUMO
Congenital diverticulum of the heart is an unusual malformation. It is frequently associated with thoracic or abdominal midline alterations and also with various types of congenital heart disease. Complications of this anomaly are rupture, peripheral embolism and heart failure. Surgical management consists of resection of the diverticulum either as an isolated operation or at the time of correction of accompanying malformations. We present six cases of congenital diverticulum of the heart, four on the right ventricle and two on the left. In one patient with Fallot's tetralogy a diverticulum was found at necropsy; in two cases the underlying malformation was double outlet ventricle; one case had pulmonary artery stenosis and two did not have associated malformations.
Assuntos
Divertículo/congênito , Cardiopatias Congênitas/patologia , Criança , Pré-Escolar , Divertículo/diagnóstico por imagem , Divertículo/patologia , Divertículo/cirurgia , Feminino , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Masculino , RadiografiaRESUMO
It is a rare condition; cases seen more frequently are usually secondary to other diseases or to surgical procedures. In this paper, a case of sacular diverticulum of urethra is reported in a newborn and was made evident by urinary obstruction. Treatment is discussed and review is made of the literature.
Assuntos
Divertículo/congênito , Doenças do Recém-Nascido/congênito , Doenças Uretrais/congênito , Divertículo/patologia , Humanos , Recém-Nascido , Doenças do Recém-Nascido/patologia , Masculino , Doenças Uretrais/patologiaAssuntos
Divertículo/patologia , Doenças Uretrais/patologia , Adulto , Fatores Etários , Idoso , Diagnóstico Diferencial , Divertículo/diagnóstico , Divertículo/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/patologia , Doenças Uretrais/diagnóstico , Doenças Uretrais/cirurgia , Infecções Urinárias/etiologiaRESUMO
The intraluminal diverticulum of the duodenum is very rare; it is an anatomical sac like formation, located in the interior of the duodenum and communicating with it through an orifice situated a the upper pole of the diverticulum where the wall is covered by mucosa on both faces. It has interesting etiopathogenic problems. We present an observation after reviewing the corresponding literature. It was a 32-year old woman suffering from moderate epigastric pains, pyrosis, chronic constipation, markedly nervous. The epigastric pain was unrelated to food or physical efforts. The physical examination showed slight epigastric pain. The gastroduodenal radiological examination showed in the second part of the duodenum a particular image, pear-shaped, homogeneous, impregnated in barium; this image was surrounded by a radiotransparent halo which changed with the patient's position. It has been seen that the diverticulum changes in size and position in agreement with the peristaltism, without ever obstructing the passage through the duodenum. A review is made of the literature and history of intraluminal diverticulum.