2ĭiverticular disease in the transverse colon or hepatic flexure, first described in 1944 by Thompson and Fox, is extremely infrequent. 1 Three main factors are known to cause diverticular disease: disordered intestinal motility, a low-fiber diet, and intestinal wall abnormalities. The present case is a rare variant of diverticular disease, given that the most commonly affected site is the sigmoid colon in white patients and the right colon in Asians. The patient was asymptomatic at one month, then at 12 months, after his original symptoms. Six weeks later, a control CAT scan was performed that showed complete resolution of the perivesicular and pericolonic inflammation. The patient improved and was released under oral treatment with the same antibiotics for another 7 days. Initial management was conservative, with bowel rest, analgesics, and double-regimen antibiotic therapy with ciprofloxacin and metronidazole for 7 days. Whether the CAT images were caused by colonic pathology or by gallbladder pathology could not be accurately determined. Because the pain continued, a computed axial tomography (CAT) scan with intravenous contrast medium was carried out ( Fig. An upper abdominal ultrasound study identified a distended gallbladder with biliary sludge and a 3 mm wall, a bile duct diameter of 5.5 mm, and the remaining parameters within normal limits. The patient’s hemoglobin level was 12.4 g/dl, platelets 336,000 cells/mm 3, leukocytes 16,400 cells/mm 3, and unaltered liver function tests. Physical examination revealed reduced peristalsis, abdominal distension due to bloating, pain in the right hypochondrium upon palpation, and a positive Murphy’s sign. The pain had no aggravating factors and partially improved with antispasmodics. He did not present with vomiting, fever, or jaundice. It began insidiously, with an intensity of 8/10, and was accompanied by abdominal bloating, hyporexia, and nausea. We present herein the case of a 56-year-old man, with an unremarkable past medical history, who came to the emergency room complaining of abdominal pain of 3-day progression in the right hypochondrium. The journal accepts original articles, scientific letters, review articles, clinical guidelines, consensuses, editorials, letters to the Editors, brief communications, and clinical images in Gastroenterology in Spanish and English for their publication. The scientific works include the areas of Clinical, Endoscopic, Surgical, and Pediatric Gastroenterology, along with related disciplines. The principal aim of the journal is to publish original work in the broad field of Gastroenterology, as well as to provide information on the specialty and related areas that is up-to-date and relevant. Its pages are open to the members of the Association, as well as to all members of the medical community interested in using this forum to publish their articles in accordance with the journal editorial policies. 2018:9123912.The Revista de Gastroenterología de México (Mexican Journal of Gastroenterology) is the official publication of the Asociación Mexicana de Gastroenterología (Mexican Association of Gastroenterology). Long-Term Consequences of Nonclosure of Mesenteric Defects after Traditional Right Colectomy. Tsai KL, Lai WH, Lee KC, Lin SE, Chang CL, Lu CC, et al. Complete mesocolic excision in right hemicolectomy: comparison between hand-assisted laparoscopic and open approaches. Sheng QS, Pan Z, Chai J, Cheng XB, Liu FL, Wang JH, et al. Minimally Invasive versus Open Approach for Right-Sided Colectomy: A Study in 12,006 Patients from the Dutch Surgical Colorectal Audit. 26 (6):497-502.īosker RJI, Van't Riet E, de Noo M, Vermaas M, Karsten TM, Pierie JP. A Comparison of Open, Laparoscopic, and Robotic Surgery in the Treatment of Right-sided Colon Cancer. Kang J, Park YA, Baik SH, Sohn SK, Lee KY. Siani LM, Ferranti F, Marzano M, De Carlo A, Quintiliani A. Laparoscopic versus open right hemicolectomy for carcinoma of the colon. Rob and Smith's Operative Surgery - Surgery of the Colon, Rectum, and Anus. Impact of Conversion from Laparoscopy to Open Surgery in Patients with Right Colon Cancer. Petrucciani N, Memeo R, Genova P, Le Roy B, Courtot L, Voron T, et al. Appendectomy or right hemicolectomy in the treatment of appendiceal carcinoid tumors?. Vol 2: Chap 152.įornaro R, Frascio M, Sticchi C, De Salvo L, Stabilini C, Mandolfino F, et al. Fischer J, Ellison EC, Upchurch GR Jr, Galandiuk S, Gould JC, Klimberg VS, et al, eds. Open and minimally invasive right hemicolectomy for cancer.
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