Lege Artis Medicinae

[Diverticulitis of the appendix]

KRUTSAY Miklós

DECEMBER 18, 2013

Lege Artis Medicinae - 2013;23(12)

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Lege Artis Medicinae

[CYCLIC RIFAXIMIN TREATMENT IN UNCOMPLICATED COLONIC DIVERTICULAR DISEASE - AN OPEN LABEL STUDY]

SIMON László, SALAMON Ágnes, FELFÖLDI Ferenc, TAM Beatrix, SÁNTA Judit, VADÁSZ Edit

[INTRODUCTION - Aquired diverticular disease of the colon is extremely common in developed countries. Poorly absorbing antibiotics may have beneficial effects on symptoms in long-term treatment. An open study was conducted to evaluate the efficiency of rifaximin in the prevention of complaints and recurrent diverticulitis. PATIENTS AND METHODS - Thirty consecutive patients with proven uncomplicated colonic diverticulosis were selected to receive rifaximin 200 mg bid for the first six days of every month, for six months. They were also advised to consume an high-fibre diet. Patients were reviewed on a monthly basis by clinical examinations; changes in symptom variables (lower abdominal pain, upper abdominal pain, bloating, tenesmus, diarrhoea, abdominal tenderness) were evaluated on a 10-point Visual Analogue Scale (VAS), and the presence of acute diverticulitis (abdominal mass, fever, US) was ruled out at every monthly visit. RESULTS - Twenty-nine of 30 patients completed the study. After six months of cyclic rifaximin treatment the global symptom score decreased in all patients compared to the baseline. Acute diverticulitis, other complications or side effects were not observed. CONCLUSIONS - In this open study cyclic administration of a relatively low dose of rifaximin in uncomplicated colonic diverticular disease resulted in the reduction of abdominal complaints and prevented recurrent diverticulitis. This effect might be explained by a reduced metabolic activity of intestinal bacterial flora.]

Hungarian Radiology

[Omental infarction diagnosed with ultrasonography]

VÁRKONYI Ildikó, VÖRÖS Péter, SZÉKELY Eszter

[INTRODUCTION - Omental infarction is a rare entity, mimicking symptoms of acute appendicitis. Although omental infarction has typical morphology, both on sonography and CT, it is rarely diagnosed preoperatively. CASE REPORT - A 4-years-old girl presenting with right lower quadrant abdominal pain underwent abdominal sonography, which revealed normal appendix and a superficial hyperechoic solid mass at the site of the pain. The patient underwent laparotomy which confirmed the presumed diagnosis of partial omental necrosis. The necrotic tissue was resected, the appendix was normal. After uneventful postoperative course the child became symptom -free and was discharged. CONCLUSION - The sonomorphology of omental infarction is typical. The suspicion of this entity should be considered as a differential diagnosis of appendicitis, especially if normal appendix can be visualized.]

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[Foreign body in the appendix]

NYITRAI Anna, KISS Imre, KIS Éva

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[Diverticulum and duplication of the appendix]

KRUTSAY Miklós

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KRUTSAY Miklós, HAJDU Mária