Complicated diverticulitis: Diagnostic precision and surgical solutions in a patient with chronic kidney disease.

Autor:	Hsieh SL; Northeast Georgia Health System, Northeast Georgia Medical Center, Transitional Year GME Program, 743 Spring Street NE Gainesville, GA 30501., Grabill N; Northeast Georgia Health System, Northeast Georgia Medical Center, General Surgery Department, 743 Spring Street NE Gainesville, GA 30501., Louis M; Northeast Georgia Health System, Northeast Georgia Medical Center, Trauma and Acute Care Surgery Department, 743 Spring Street NE Gainesville, GA 30501., Kuhn B; Northeast Georgia Health System, Northeast Georgia Medical Center, Trauma and Acute Care Surgery Department, 743 Spring Street NE Gainesville, GA 30501.
Jazyk:	angličtina
Zdroj:	Radiology case reports [Radiol Case Rep] 2024 Oct 30; Vol. 20 (1), pp. 346-351. Date of Electronic Publication: 2024 Oct 30 (Print Publication: 2025).
DOI:	10.1016/j.radcr.2024.10.039
Abstrakt:	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. (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
Databáze:	MEDLINE
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