The Experts below are selected from a list of 207 Experts worldwide ranked by ideXlab platform

Jesse E. Thompson - One of the best experts on this subject based on the ideXlab platform.

  • Cecal diverticulitis: A continuing diagnostic dilemma
    World Journal of Surgery, 1991
    Co-Authors: P. J. Schmit, Robert S. Bennion, Jesse E. Thompson
    Abstract:

    Cecal diverticulitis is a rare entity and remains a difficult diagnostic problem. A retrospective review was undertaken of 16 patients (11 men, 5 women; average age, 33.2 years) with a pathologic diagnosis of cecal or right Colon Diverticulosis who received treatment from 1979 to the present. Preoperative symptoms were difficult to distinguish from appendicitis. The majority complained of right lower quadrant pain and tenderness. Diagnostic studies were not helpful. Preoperative diagnosis was appendicitis in 88% (14 of 16) and correct in 1 patient (6%). At exploratory celiotomy, the surgeon was able to make the diagnosis of cecal diverticulitis in 9 (60%) of the 15 patients in whom the correct diagnosis had not been made preoperatively. Neoplasm was suspected in 5 patients, and an appendiceal abscess was suspected in 1. Treatment was colectomy in 9 and local excision in 4 patients. In 3 patients, the inflamed diverticulum was left in situ at initial exploration; all underwent later excision, one of these urgently for sepsis. No patient died; however, one anastomotic leak requiring reoperation occurred. On the basis of this experience, we recommend excisional therapy in all cases in which the intraoperative diagnosis is certain. Suspicion of a neoplastic process continues to prompt colectomy in an emergency setting.

  • Cecal diverticulitis: A continuing diagnostic dilemma
    World Journal of Surgery, 1991
    Co-Authors: P. J. Schmit, Robert S. Bennion, Jesse E. Thompson
    Abstract:

    La diverticulite cécale est une entité rare qui pose un délicat problème diagnostique. On a fait l'étude rétrospective de 16 patients (11 hommes, 5 femmes; âge moyen 33.2 ans) qui, avec un diagnostic de diverticulose du caecum ou du côlon droit confirmé par l'examen anatomopathologique, ont été traités de 1979 à aujourd'hui. La plupart d'entre eux se plaignaient de douleur spontanée et provoquée dans la fosse iliaque droite. Les investigations à visée diagnostique n'ont pas donné de résultats. Le diagnostic avant l'intervention était appendicite pour 87% des patients et juste chez un (6%). A la laparotomie exploratrice, le chirurgien est arrivé à poser le diagnostic de diverticulite cécale chez 9 (60%) des 15 patients pour lesquels le bon diagnostic n'avait pas été suggéré avant l'intervention. Une néoplasie était évoquée pour 5 patients et un abcès appendiculaire pour un. Le traitement a été la colectomie pour 9 patients et l'excision locale pour 4. Chez 3 patients, le diverticule inflammatoire a été laissé en place à la première intervention; tous ont eu une excision par la suite, l'un d'entre eux en urgence pour sepsis. Il n'y a pas eu de mort; mais une fuite anastomotique dans un cas a nécessité une nouvelle intervention. D'après ces données, nous recommandons l'exérèse pour tous les cas où le diagnostic peropératoire est sûr. Soupçonner un processus néoplasique conduit à la colectomie en urgence. La diverticulitis cecal es una entidad clínica rara que continúa siendo un problema diagnóstico difícil. Se realizó la revisión retrospectiva en 16 pacientes (11 hombres, 5 mujeres; promedio de edad 33.2 años) con el diagnóstico patológico de Diverticulosis cecal o del Colon derecho, tratados entre 1979 y el presente. Los síntomas preoperatorios fueron difíciles de diferenciar de apendicitis; la mayoría presentaba dolor, espontáneo y a la palpación, sobre el cuadrante inferior derecho del abdomen. Los estudios diagnósticos no fueron de ayuda. El diagnóstico preoperatorio fue apendicitis en 87% (14 de 16) de los casos, y correcto en 1 paciente (6%). En la celiotomía exploratoria el cirujano pudo establecer el diagnóstico en 9 (60%) de 15 pacientes en quienes el diagnóstico correcto no fue establecido preoperatoriamente. Se sospechó neoplasma en 5, y absceso apendicular en 1. El tratamiento consitió en colectomía en 9 y resección local en 4. El divertículo inflamado fue dejado in situ en la exploración inicial en 3; en todos se practicó resección local más tarde, uno de ellos de urgencia por sepsis. Ningún paciente murió; sin embargo, se presentó una falla anastomótica que requirió reoperación. Con base en esta experiencia, nosotros recomendamos resección en todos los casos en los cuales hay certeza en cuanto al diagnóstico intraoperatorio. La sospecha de un proceso neoplásico continúa motivando la colectomia en la situatión de emergencia. Cecal diverticulitis is a rare entity and remains a difficult diagnostic problem. A retrospective review was undertaken of 16 patients (11 men, 5 women; average age, 33.2 years) with a pathologic diagnosis of cecal or right Colon Diverticulosis who received treatment from 1979 to the present. Preoperative symptoms were difficult to distinguish from appendicitis. The majority complained of right lower quadrant pain and tenderness. Diagnostic studies were not helpful. Preoperative diagnosis was appendicitis in 88% (14 of 16) and correct in 1 patient (6%). At exploratory celiotomy, the surgeon was able to make the diagnosis of cecal diverticulitis in 9 (60%) of the 15 patients in whom the correct diagnosis had not been made preoperatively. Neoplasm was suspected in 5 patients, and an appendiceal abscess was suspected in 1. Treatment was colectomy in 9 and local excision in 4 patients. In 3 patients, the inflamed diverticulum was left in situ at initial exploration; all underwent later excision, one of these urgently for sepsis. No patient died; however, one anastomotic leak requiring reoperation occurred. On the basis of this experience, we recommend excisional therapy in all cases in which the intraoperative diagnosis is certain. Suspicion of a neoplastic process continues to prompt colectomy in an emergency setting.

David Baxter - One of the best experts on this subject based on the ideXlab platform.

  • Trends in dietary fiber intake in Japan over the last century
    European Journal of Nutrition, 2002
    Co-Authors: Shigeyuki Nakaji, Kazuo Sugawara, Dausuke Saito, Yoshiko Yoshioka, Domhnall Macauley, Terry Bradley, George Kernohan, David Baxter
    Abstract:

    Background: Insufficient intake of dietary fiber (DF) is currently a major problem in the overall promotion of health in the general population in Japan. Aim of the study: To analyze the time trends in DF intake, including DF density (total DF intake/1,000 kcal), and the ratio of water-insoluble fiber to water-soluble fiber (IS ratio) in Japan. Methods: The time trend in DF intake in Japan was calculated from data compiled in the Japanese National Nutrition Survey. Results: The mean daily DF intake (total DF intake) in 1952 was 20.5 g/day, which rapidly declined to about 70 % of the 1952 level in 1970, after which there was little change to 1998. DF density in 1952 was 9.7 g/1000 kcal, which declined by about 30 % in 1970, and remained at about the same level to 1998. The IS ratio has remained stable over this period. Whereas total DF intake and DF density in Japan are similar to those in Western countries, the IS ratios are higher in Japan. Therefore, the higher incidence of, and mortality from, Colon Diverticulosis, coronary heart disease, hyperlipidemia, etc., which are all thought to be related to fiber deficiency, in Western countries compared to Japan might be due to the differences in the IS ratio. Conclusions: A decline in total DF intake and DF density is predicted for Japan in the future, because these parameters were lower among the younger generation. This may be due to the marked changes in the dietary habits of the younger generation, and is a problematic trend for Japanese health.

Odette Boutross-tadross - One of the best experts on this subject based on the ideXlab platform.

  • Diverticular disease of the right Colon
    BMC Research Notes, 2011
    Co-Authors: Jasim M Radhi, Jennifer A Ramsay, Odette Boutross-tadross
    Abstract:

    Background The incidence of Colonic diverticular disease varies with national origin, cultural background and diet. The frequency of this disease increases with advancing age. Right-sided diverticular disease is uncommon and reported to occur in 1-2% of surgical specimens in European and American series. In contrast the disease is more prevalent and reported in 43-50% of specimens in Asian series. Various lines of evidence suggest this variation may represent hereditary differences. The aim of the study is to report all cases of right sided diverticular disease underwent surgical resection or identified during pathological examination of right hemicoloectomy specimens Methods A retrospective review of all surgical specimens with right sided Colonic diverticular disease selected from a larger database of all Colonic Diverticulosis and diverticulitis surgical specimen reported between January 1993 and December 2010 at the Pathology Department McMaster University Medical Centre Canada. The clinical and pathological features of these cases were reviewed Results The review identified 15 cases of right Colon Diverticulosis. The clinical diagnoses of these cases were appendicitis, diverticulitis or adenocarcinoma. Eight cases of single congenital perforated diverticuli were identified and seven cases were incidental multiple acquired diverticuli found in specimen resected for right side Colonic carcinomas/large adenomas. Laparotomy or laparoscopic assisted haemicolectomies were done for all cases. Pathological examination showed caecal wall thickening with inflammation associated with perforated diverticuli. Histology confirmed true solitary diverticuli that exhibited in two cases thick walled vessels in the submucosa and muscular layer indicating vascular malformation/angiodysplasia. Acquired diverticuli tend to be multiple and are mostly seen in specimens resected for neoplastic right Colon diseases. Conclusion Single true diverticular disease of the right Colon is usually of congenital type and affects younger age group and may be associated with angiodysplasia in some cases. Multiple false diverticuli are more seen in association with caecal carcinoma or large adenomas. These are usually asymptomatic and are more seen in older patients. However this study dose not reflects the true incidence of the disease in the general population.

Shigeyuki Nakaji - One of the best experts on this subject based on the ideXlab platform.

  • Trends in dietary fiber intake in Japan over the last century
    European Journal of Nutrition, 2002
    Co-Authors: Shigeyuki Nakaji, Kazuo Sugawara, Dausuke Saito, Yoshiko Yoshioka, Domhnall Macauley, Terry Bradley, George Kernohan, David Baxter
    Abstract:

    Background: Insufficient intake of dietary fiber (DF) is currently a major problem in the overall promotion of health in the general population in Japan. Aim of the study: To analyze the time trends in DF intake, including DF density (total DF intake/1,000 kcal), and the ratio of water-insoluble fiber to water-soluble fiber (IS ratio) in Japan. Methods: The time trend in DF intake in Japan was calculated from data compiled in the Japanese National Nutrition Survey. Results: The mean daily DF intake (total DF intake) in 1952 was 20.5 g/day, which rapidly declined to about 70 % of the 1952 level in 1970, after which there was little change to 1998. DF density in 1952 was 9.7 g/1000 kcal, which declined by about 30 % in 1970, and remained at about the same level to 1998. The IS ratio has remained stable over this period. Whereas total DF intake and DF density in Japan are similar to those in Western countries, the IS ratios are higher in Japan. Therefore, the higher incidence of, and mortality from, Colon Diverticulosis, coronary heart disease, hyperlipidemia, etc., which are all thought to be related to fiber deficiency, in Western countries compared to Japan might be due to the differences in the IS ratio. Conclusions: A decline in total DF intake and DF density is predicted for Japan in the future, because these parameters were lower among the younger generation. This may be due to the marked changes in the dietary habits of the younger generation, and is a problematic trend for Japanese health.

  • Proposal for recommended level of dietary fiber intake in Japan
    Nutrition Research, 1996
    Co-Authors: Bunpei Mori, Shigeyuki Nakaji, Kazuo Sugawara, Masanori Ohta, Satoru Iwane, Akihiro Munakata, Yutaka Yoshida
    Abstract:

    Abstract In this report, we attempt to propose a recommended level of dietary fiber (DF) for the Japanese from several epidemiological reports. The authors previously investigated the daily DF intake in 50 patients with Colon polyp, 33 patients with Colon Diverticulosis, 45 patients with colorectal cancer, and two groups 84 and 45 control subjects; the values obtained were 18.2, 17.4, 14.9, and 21.1 and 19.9 g, respectively. In another study, of the 5 regions in Japan, in only one, Aomori, where the rate of the Colon Diverticulosis detection was the lowest, did the DF intake exceed 20 g. Furthermore, in Japan the incidence of colorectal cancer showed a marked increase after 1955. It was assumed that the period between the diagnosis of colorectal cancer and death was 15 years, and that the DF intakes at this time (before 1940) to had contributed to the development of the disease. However unfortunately daily DF intake before 1940 in Japan were unknown, and we have only data 25.0 g in 1946. Thus, it is proposed that the recommended level for daily DF intake in Japanese be set at about 20–25 g, i.e. 10 g per 1,000 kcal.

P. J. Schmit - One of the best experts on this subject based on the ideXlab platform.

  • Cecal diverticulitis: A continuing diagnostic dilemma
    World Journal of Surgery, 1991
    Co-Authors: P. J. Schmit, Robert S. Bennion, Jesse E. Thompson
    Abstract:

    Cecal diverticulitis is a rare entity and remains a difficult diagnostic problem. A retrospective review was undertaken of 16 patients (11 men, 5 women; average age, 33.2 years) with a pathologic diagnosis of cecal or right Colon Diverticulosis who received treatment from 1979 to the present. Preoperative symptoms were difficult to distinguish from appendicitis. The majority complained of right lower quadrant pain and tenderness. Diagnostic studies were not helpful. Preoperative diagnosis was appendicitis in 88% (14 of 16) and correct in 1 patient (6%). At exploratory celiotomy, the surgeon was able to make the diagnosis of cecal diverticulitis in 9 (60%) of the 15 patients in whom the correct diagnosis had not been made preoperatively. Neoplasm was suspected in 5 patients, and an appendiceal abscess was suspected in 1. Treatment was colectomy in 9 and local excision in 4 patients. In 3 patients, the inflamed diverticulum was left in situ at initial exploration; all underwent later excision, one of these urgently for sepsis. No patient died; however, one anastomotic leak requiring reoperation occurred. On the basis of this experience, we recommend excisional therapy in all cases in which the intraoperative diagnosis is certain. Suspicion of a neoplastic process continues to prompt colectomy in an emergency setting.

  • Cecal diverticulitis: A continuing diagnostic dilemma
    World Journal of Surgery, 1991
    Co-Authors: P. J. Schmit, Robert S. Bennion, Jesse E. Thompson
    Abstract:

    La diverticulite cécale est une entité rare qui pose un délicat problème diagnostique. On a fait l'étude rétrospective de 16 patients (11 hommes, 5 femmes; âge moyen 33.2 ans) qui, avec un diagnostic de diverticulose du caecum ou du côlon droit confirmé par l'examen anatomopathologique, ont été traités de 1979 à aujourd'hui. La plupart d'entre eux se plaignaient de douleur spontanée et provoquée dans la fosse iliaque droite. Les investigations à visée diagnostique n'ont pas donné de résultats. Le diagnostic avant l'intervention était appendicite pour 87% des patients et juste chez un (6%). A la laparotomie exploratrice, le chirurgien est arrivé à poser le diagnostic de diverticulite cécale chez 9 (60%) des 15 patients pour lesquels le bon diagnostic n'avait pas été suggéré avant l'intervention. Une néoplasie était évoquée pour 5 patients et un abcès appendiculaire pour un. Le traitement a été la colectomie pour 9 patients et l'excision locale pour 4. Chez 3 patients, le diverticule inflammatoire a été laissé en place à la première intervention; tous ont eu une excision par la suite, l'un d'entre eux en urgence pour sepsis. Il n'y a pas eu de mort; mais une fuite anastomotique dans un cas a nécessité une nouvelle intervention. D'après ces données, nous recommandons l'exérèse pour tous les cas où le diagnostic peropératoire est sûr. Soupçonner un processus néoplasique conduit à la colectomie en urgence. La diverticulitis cecal es una entidad clínica rara que continúa siendo un problema diagnóstico difícil. Se realizó la revisión retrospectiva en 16 pacientes (11 hombres, 5 mujeres; promedio de edad 33.2 años) con el diagnóstico patológico de Diverticulosis cecal o del Colon derecho, tratados entre 1979 y el presente. Los síntomas preoperatorios fueron difíciles de diferenciar de apendicitis; la mayoría presentaba dolor, espontáneo y a la palpación, sobre el cuadrante inferior derecho del abdomen. Los estudios diagnósticos no fueron de ayuda. El diagnóstico preoperatorio fue apendicitis en 87% (14 de 16) de los casos, y correcto en 1 paciente (6%). En la celiotomía exploratoria el cirujano pudo establecer el diagnóstico en 9 (60%) de 15 pacientes en quienes el diagnóstico correcto no fue establecido preoperatoriamente. Se sospechó neoplasma en 5, y absceso apendicular en 1. El tratamiento consitió en colectomía en 9 y resección local en 4. El divertículo inflamado fue dejado in situ en la exploración inicial en 3; en todos se practicó resección local más tarde, uno de ellos de urgencia por sepsis. Ningún paciente murió; sin embargo, se presentó una falla anastomótica que requirió reoperación. Con base en esta experiencia, nosotros recomendamos resección en todos los casos en los cuales hay certeza en cuanto al diagnóstico intraoperatorio. La sospecha de un proceso neoplásico continúa motivando la colectomia en la situatión de emergencia. Cecal diverticulitis is a rare entity and remains a difficult diagnostic problem. A retrospective review was undertaken of 16 patients (11 men, 5 women; average age, 33.2 years) with a pathologic diagnosis of cecal or right Colon Diverticulosis who received treatment from 1979 to the present. Preoperative symptoms were difficult to distinguish from appendicitis. The majority complained of right lower quadrant pain and tenderness. Diagnostic studies were not helpful. Preoperative diagnosis was appendicitis in 88% (14 of 16) and correct in 1 patient (6%). At exploratory celiotomy, the surgeon was able to make the diagnosis of cecal diverticulitis in 9 (60%) of the 15 patients in whom the correct diagnosis had not been made preoperatively. Neoplasm was suspected in 5 patients, and an appendiceal abscess was suspected in 1. Treatment was colectomy in 9 and local excision in 4 patients. In 3 patients, the inflamed diverticulum was left in situ at initial exploration; all underwent later excision, one of these urgently for sepsis. No patient died; however, one anastomotic leak requiring reoperation occurred. On the basis of this experience, we recommend excisional therapy in all cases in which the intraoperative diagnosis is certain. Suspicion of a neoplastic process continues to prompt colectomy in an emergency setting.