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Mistakes in acute diverticulitis and how to avoid them

Anna A.W. van Geloven, Simone Rottier, Marja A. Boermeester

Summary

AI Generated

This material addresses 10 frequent mistakes in managing acute diverticulitis, covering terminology, diagnosis, and treatment decisions including antibiotics, radiological interventions, and surgery.

  • Distinguishing between uncomplicated and complicated acute diverticulitis is essential because treatment strategies differ between the two
  • Treatment topics include decisions about omitting or administering antibiotics, radiological interventions, and various surgical aspects
  • The incidence of acute diverticulitis is rising worldwide and represents a considerable burden on healthcare systems
  • The discussion combines evidence-based content with clinical experience where evidence is lacking
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Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Painter NS. Diverticular disease of the colon. Br Med J 1968; 3: 475–479. [Link]
2.
Stollman N and Raskin JB. Diverticular disease of the colon. Lancet 2004; 363: 631–639. [Link]
3.
Hinchey EJ, et al. Treatment of perforated diverticular disease of the colon. Adv Surg 1978; 12: 85–109. [Link]
4.
Wasvary H, et al. Same hospitalization resection for acute diverticulitis. Am Surg 1999; 65: 632–635. [Link]
5.
Burkitt DP, et al. Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease. Lancet 1972; 2: 1408–1412. [Link]
6.
Stam MA, et al. An unrestricted diet for uncomplicated diverticulitis is safe: results of a prospective diverticulitis diet study. Colorectal Dis 2017; 19: 372–377. [Link]
7.
van de Wall BJ, et al. Dietary restrictions for acute diverticulitis: evidence-based or expert opinion? Int J Colorectal Dis 2013; 28: 1287–1293. [Link]
8.
Rottier SJ, et al. Complicated disease course in initially computed tomography-proven uncomplicated acute diverticulitis. Surg Infect (Larchmt) Epub ahead of print (August 14 2019). doi: 10.1089/sur.2018.289. [Link]
9.
Gregersen R, et al. Treatment of patients with acute colonic diverticulitis complicated by abscess formation: A systematic review. Int J Surg 2016; 35: 201–208. [Link]
10.
Lambrichts DPV, et al. Multicentre study of non-surgical management of diverticulitis with abscess formation. Br J Surg 2019; 106: 458–466. [Link]
11.
Nielsen K, et al. The limited role of ultrasound in the diagnostic process of colonic diverticulitis. World J Surg 2014; 38: 1814–1818. [Link]
12.
Lameris W, et al. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol 2008; 18: 2498–2511. [Link]
13.
van Randen A, et al. A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain. Eur Radiol 2011; 21: 1535–1545. [Link]
14.
Bridoux V, et al. Elective operation after acute complicated diverticulitis: is it still mandatory? World J Gastroenterol 2014; 20: 8166–8172. [Link]
15.
Sallinen VJ, et al. Nonoperative management of perforated diverticulitis with extraluminal air is safe and effective in selected patients. Dis Colon Rectum 2014; 57: 875–881. [Link]
16.
van Dijk ST, et al. A systematic review of pericolic extraluminal air in left-sided acute colonic diverticulitis. Surg Infect (Larchmt) 2018; 19: 362–368. [Link]
17.
Colas PA, et al. Failure of conservative treatment of acute diverticulitis with extradigestive air. World J Surg 2017; 41: 1890–1895. [Link]
18.
Daniels L, et al. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. Br J Surg 2017; 104: 52–61. [Link]
19.
Chabok A, et al. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012; 99: 532–539. [Link]
20.
van Dijk ST, et al. Long-term effects of omitting antibiotics in uncomplicated acute diverticulitis. Am J Gastroenterol 2018; 113: 1045–1052. [Link]
21.
van Dijk ST, et al. A systematic review and meta-analysis of outpatient treatment for acute diverticulitis. Int J Colorectal Dis 2018; 33: 505–512. [Link]
22.
de Boer MGJ, et al. The Dutch national guideline ‘Acute Diverticulitis’, https://richtlijnendatabase.nl/richtlijn/acute_diverticulitis/startpagina_-_acute_diverticulitis.html#verantwoording (2018, accessed 28 November 2019 ; in Dutch). [Link]
23.
Andersen JC, et al. Danish national guidelines for treatment of diverticular disease. Dan Med J 2012; 59: C4453. [Link]
24.
Binda GA, et al. Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines. Tech Coloproctol 2015; 19: 615–626. [Link]
25.
Feingold D, et al. Practice parameters for the treatment of sigmoid diverticulitis. Dis Colon Rectum 2014; 57: 284–294. [Link]
26.
Kruis W, et al. Diverticular disease: Guidelines of the German Society for Gastroenterology, Digestive and Metabolic Diseases and the German Society for General and Visceral Surgery. Digestion 2014; 90: 190–207. [Link]
27.
Stollman N, et al. American Gastroenterological Association Institute guideline on the management of acute diverticulitis. Gastroenterology 2015; 149: 1944–1949. [Link]
28.
Wilkins T, et al. Diagnosis and management of acute diverticulitis. Am Fam Physician 2013; 87: 612–620. [Link]
29.
Rottier SJ, et al. Meta-analysis of the role of colonoscopy after an episode of left-sided acute diverticulitis. Br J Surg 2019; 106: 988–997. [Link]
30.
Binda GA, et al. Primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a prematurely terminated randomized controlled trial. Colorectal Dis 2012; 14: 1403–1410. [Link]
31.
Bridoux V, et al. Hartmann's procedure or primary anastomosis for generalized peritonitis due to perforated diverticulitis: a prospective multicenter randomized trial (DIVERTI). J Am Coll Surg 2017; 225: 798–805. [Link]
32.
Oberkofler CE, et al. A multicenter randomized clinical trial of primary anastomosis or Hartmann's procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg 2012; 256: 819–826. [Link]
33.
Lambrichts DPV, et al. Hartmann's procedure versus sigmoidectomy with primary anastomosis for perforated diverticulitis with purulent or faecal peritonitis (LADIES): a multicentre, parallel-group, randomised, open-label, superiority trial. Lancet Gastroenterol Hepatol 2019; 4: 599–610. [Link]
34.
Cauley CE, et al. Use of primary anastomosis with diverting ileostomy in patients with acute diverticulitis requiring urgent operative intervention. Dis Colon Rectum 2018; 61: 586–592. [Link]

Abstract

Acute diverticulitis is an inflammatory complication of diverticulosis and can either be uncomplicated or complicated. Making the distinction between uncomplicated and complicated acute diverticulitis is essential because treatment strategies differ between the two. Here, we discuss 10 mistakes frequently made when managing patients with acute diverticulitis. We focus on using the correct terminology, diagnostic preference and several treatment options, such as omitting or administering antibiotics, radiological interventions and various aspects of surgery. Acute diverticulitis is an important topic because its incidence is rising worldwide and it is becoming a considerable burden on healthcare systems. Most of the discussion included here is evidence-based, supplemented with many years’ combined clinical experience where evidence is lacking.

Topics

Endoscopy Radiology & Imaging Surgery

Citation

Cite this article as: Rottier SJ, et al. Mistakes in acute diverticulitis and how to avoid them. UEG Education 2019; 19: 31–35.

Published

2019

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UEG Mistakes In Articles
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Mistakes in hepatitis C and how to avoid them

Ana Catarina Garcia, Gonçalo Alexandrino

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Painter NS. Diverticular disease of the colon. Br Med J 1968; 3: 475–479. [Link]
2.
Stollman N and Raskin JB. Diverticular disease of the colon. Lancet 2004; 363: 631–639. [Link]
3.
Hinchey EJ, et al. Treatment of perforated diverticular disease of the colon. Adv Surg 1978; 12: 85–109. [Link]
4.
Wasvary H, et al. Same hospitalization resection for acute diverticulitis. Am Surg 1999; 65: 632–635. [Link]
5.
Burkitt DP, et al. Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease. Lancet 1972; 2: 1408–1412. [Link]
6.
Stam MA, et al. An unrestricted diet for uncomplicated diverticulitis is safe: results of a prospective diverticulitis diet study. Colorectal Dis 2017; 19: 372–377. [Link]
7.
van de Wall BJ, et al. Dietary restrictions for acute diverticulitis: evidence-based or expert opinion? Int J Colorectal Dis 2013; 28: 1287–1293. [Link]
8.
Rottier SJ, et al. Complicated disease course in initially computed tomography-proven uncomplicated acute diverticulitis. Surg Infect (Larchmt) Epub ahead of print (August 14 2019). doi: 10.1089/sur.2018.289. [Link]
9.
Gregersen R, et al. Treatment of patients with acute colonic diverticulitis complicated by abscess formation: A systematic review. Int J Surg 2016; 35: 201–208. [Link]
10.
Lambrichts DPV, et al. Multicentre study of non-surgical management of diverticulitis with abscess formation. Br J Surg 2019; 106: 458–466. [Link]
11.
Nielsen K, et al. The limited role of ultrasound in the diagnostic process of colonic diverticulitis. World J Surg 2014; 38: 1814–1818. [Link]
12.
Lameris W, et al. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol 2008; 18: 2498–2511. [Link]
13.
van Randen A, et al. A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain. Eur Radiol 2011; 21: 1535–1545. [Link]
14.
Bridoux V, et al. Elective operation after acute complicated diverticulitis: is it still mandatory? World J Gastroenterol 2014; 20: 8166–8172. [Link]
15.
Sallinen VJ, et al. Nonoperative management of perforated diverticulitis with extraluminal air is safe and effective in selected patients. Dis Colon Rectum 2014; 57: 875–881. [Link]
16.
van Dijk ST, et al. A systematic review of pericolic extraluminal air in left-sided acute colonic diverticulitis. Surg Infect (Larchmt) 2018; 19: 362–368. [Link]
17.
Colas PA, et al. Failure of conservative treatment of acute diverticulitis with extradigestive air. World J Surg 2017; 41: 1890–1895. [Link]
18.
Daniels L, et al. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. Br J Surg 2017; 104: 52–61. [Link]
19.
Chabok A, et al. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012; 99: 532–539. [Link]
20.
van Dijk ST, et al. Long-term effects of omitting antibiotics in uncomplicated acute diverticulitis. Am J Gastroenterol 2018; 113: 1045–1052. [Link]
21.
van Dijk ST, et al. A systematic review and meta-analysis of outpatient treatment for acute diverticulitis. Int J Colorectal Dis 2018; 33: 505–512. [Link]
22.
de Boer MGJ, et al. The Dutch national guideline ‘Acute Diverticulitis’, https://richtlijnendatabase.nl/richtlijn/acute_diverticulitis/startpagina_-_acute_diverticulitis.html#verantwoording (2018, accessed 28 November 2019 ; in Dutch). [Link]
23.
Andersen JC, et al. Danish national guidelines for treatment of diverticular disease. Dan Med J 2012; 59: C4453. [Link]
24.
Binda GA, et al. Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines. Tech Coloproctol 2015; 19: 615–626. [Link]
25.
Feingold D, et al. Practice parameters for the treatment of sigmoid diverticulitis. Dis Colon Rectum 2014; 57: 284–294. [Link]
26.
Kruis W, et al. Diverticular disease: Guidelines of the German Society for Gastroenterology, Digestive and Metabolic Diseases and the German Society for General and Visceral Surgery. Digestion 2014; 90: 190–207. [Link]
27.
Stollman N, et al. American Gastroenterological Association Institute guideline on the management of acute diverticulitis. Gastroenterology 2015; 149: 1944–1949. [Link]
28.
Wilkins T, et al. Diagnosis and management of acute diverticulitis. Am Fam Physician 2013; 87: 612–620. [Link]
29.
Rottier SJ, et al. Meta-analysis of the role of colonoscopy after an episode of left-sided acute diverticulitis. Br J Surg 2019; 106: 988–997. [Link]
30.
Binda GA, et al. Primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a prematurely terminated randomized controlled trial. Colorectal Dis 2012; 14: 1403–1410. [Link]
31.
Bridoux V, et al. Hartmann's procedure or primary anastomosis for generalized peritonitis due to perforated diverticulitis: a prospective multicenter randomized trial (DIVERTI). J Am Coll Surg 2017; 225: 798–805. [Link]
32.
Oberkofler CE, et al. A multicenter randomized clinical trial of primary anastomosis or Hartmann's procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg 2012; 256: 819–826. [Link]
33.
Lambrichts DPV, et al. Hartmann's procedure versus sigmoidectomy with primary anastomosis for perforated diverticulitis with purulent or faecal peritonitis (LADIES): a multicentre, parallel-group, randomised, open-label, superiority trial. Lancet Gastroenterol Hepatol 2019; 4: 599–610. [Link]
34.
Cauley CE, et al. Use of primary anastomosis with diverting ileostomy in patients with acute diverticulitis requiring urgent operative intervention. Dis Colon Rectum 2018; 61: 586–592. [Link]

Abstract

Hepatitis C virus (HCV) infection remains an important global health concern. It is estimated that there are approximately 50 million people infected with HCV globally, with around 1 million new infections each year and about 242,000 deaths annually attributed to HCV-related complications. Most acute HCV infections (55–85%) become chronic due to the virus’s effective evasion strategies, with spontaneous clearance being rare once chronicity is established. This condition often progresses silently, with many individuals unaware of their infection until advanced liver damage has occurred. If left untreated, HCV can lead to severe complications, including liver cirrhosis and hepatocellular carcinoma (HCC). HCV transmission occurs mainly through percutaneous exposure to infected blood. HCV can also spread from mother to infant (vertical transmission) and, less frequently, via sexual contact.1,2 In recent years, the introduction of oral direct-acting antivirals (DAAs), with remarkable safety and effectiveness profiles, has led to a sustained virological response (SVR) in virtually all (>97%) HCV-infected patients, regardless of HCV genotype or disease stage. However, significant barriers remain, such as issues with diagnosis, access to treatment and awareness of the disease.

Here, we discuss some of the misconceptions in HCV management and provide a practical management approach grounded in evidence and clinical experience.

Topics

Hepatobiliary

Citation

Garcia A.C and Alexandrino G. Mistakes in hepatits C and how to avoid them. UEG Education 2025; 25: 14-17.

Published

2025

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UEG Podcast Episode
UEG Podcast
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Ian Gralnek on UEG Week 2024

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Summary

AI Generated

Summary is not available for this content yet.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Topics

Endoscopy

Published

2025

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Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

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Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Painter NS. Diverticular disease of the colon. Br Med J 1968; 3: 475–479. [Link]
2.
Stollman N and Raskin JB. Diverticular disease of the colon. Lancet 2004; 363: 631–639. [Link]
3.
Hinchey EJ, et al. Treatment of perforated diverticular disease of the colon. Adv Surg 1978; 12: 85–109. [Link]
4.
Wasvary H, et al. Same hospitalization resection for acute diverticulitis. Am Surg 1999; 65: 632–635. [Link]
5.
Burkitt DP, et al. Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease. Lancet 1972; 2: 1408–1412. [Link]
6.
Stam MA, et al. An unrestricted diet for uncomplicated diverticulitis is safe: results of a prospective diverticulitis diet study. Colorectal Dis 2017; 19: 372–377. [Link]
7.
van de Wall BJ, et al. Dietary restrictions for acute diverticulitis: evidence-based or expert opinion? Int J Colorectal Dis 2013; 28: 1287–1293. [Link]
8.
Rottier SJ, et al. Complicated disease course in initially computed tomography-proven uncomplicated acute diverticulitis. Surg Infect (Larchmt) Epub ahead of print (August 14 2019). doi: 10.1089/sur.2018.289. [Link]
9.
Gregersen R, et al. Treatment of patients with acute colonic diverticulitis complicated by abscess formation: A systematic review. Int J Surg 2016; 35: 201–208. [Link]
10.
Lambrichts DPV, et al. Multicentre study of non-surgical management of diverticulitis with abscess formation. Br J Surg 2019; 106: 458–466. [Link]
11.
Nielsen K, et al. The limited role of ultrasound in the diagnostic process of colonic diverticulitis. World J Surg 2014; 38: 1814–1818. [Link]
12.
Lameris W, et al. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol 2008; 18: 2498–2511. [Link]
13.
van Randen A, et al. A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain. Eur Radiol 2011; 21: 1535–1545. [Link]
14.
Bridoux V, et al. Elective operation after acute complicated diverticulitis: is it still mandatory? World J Gastroenterol 2014; 20: 8166–8172. [Link]
15.
Sallinen VJ, et al. Nonoperative management of perforated diverticulitis with extraluminal air is safe and effective in selected patients. Dis Colon Rectum 2014; 57: 875–881. [Link]
16.
van Dijk ST, et al. A systematic review of pericolic extraluminal air in left-sided acute colonic diverticulitis. Surg Infect (Larchmt) 2018; 19: 362–368. [Link]
17.
Colas PA, et al. Failure of conservative treatment of acute diverticulitis with extradigestive air. World J Surg 2017; 41: 1890–1895. [Link]
18.
Daniels L, et al. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. Br J Surg 2017; 104: 52–61. [Link]
19.
Chabok A, et al. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012; 99: 532–539. [Link]
20.
van Dijk ST, et al. Long-term effects of omitting antibiotics in uncomplicated acute diverticulitis. Am J Gastroenterol 2018; 113: 1045–1052. [Link]
21.
van Dijk ST, et al. A systematic review and meta-analysis of outpatient treatment for acute diverticulitis. Int J Colorectal Dis 2018; 33: 505–512. [Link]
22.
de Boer MGJ, et al. The Dutch national guideline ‘Acute Diverticulitis’, https://richtlijnendatabase.nl/richtlijn/acute_diverticulitis/startpagina_-_acute_diverticulitis.html#verantwoording (2018, accessed 28 November 2019 ; in Dutch). [Link]
23.
Andersen JC, et al. Danish national guidelines for treatment of diverticular disease. Dan Med J 2012; 59: C4453. [Link]
24.
Binda GA, et al. Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines. Tech Coloproctol 2015; 19: 615–626. [Link]
25.
Feingold D, et al. Practice parameters for the treatment of sigmoid diverticulitis. Dis Colon Rectum 2014; 57: 284–294. [Link]
26.
Kruis W, et al. Diverticular disease: Guidelines of the German Society for Gastroenterology, Digestive and Metabolic Diseases and the German Society for General and Visceral Surgery. Digestion 2014; 90: 190–207. [Link]
27.
Stollman N, et al. American Gastroenterological Association Institute guideline on the management of acute diverticulitis. Gastroenterology 2015; 149: 1944–1949. [Link]
28.
Wilkins T, et al. Diagnosis and management of acute diverticulitis. Am Fam Physician 2013; 87: 612–620. [Link]
29.
Rottier SJ, et al. Meta-analysis of the role of colonoscopy after an episode of left-sided acute diverticulitis. Br J Surg 2019; 106: 988–997. [Link]
30.
Binda GA, et al. Primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a prematurely terminated randomized controlled trial. Colorectal Dis 2012; 14: 1403–1410. [Link]
31.
Bridoux V, et al. Hartmann's procedure or primary anastomosis for generalized peritonitis due to perforated diverticulitis: a prospective multicenter randomized trial (DIVERTI). J Am Coll Surg 2017; 225: 798–805. [Link]
32.
Oberkofler CE, et al. A multicenter randomized clinical trial of primary anastomosis or Hartmann's procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg 2012; 256: 819–826. [Link]
33.
Lambrichts DPV, et al. Hartmann's procedure versus sigmoidectomy with primary anastomosis for perforated diverticulitis with purulent or faecal peritonitis (LADIES): a multicentre, parallel-group, randomised, open-label, superiority trial. Lancet Gastroenterol Hepatol 2019; 4: 599–610. [Link]
34.
Cauley CE, et al. Use of primary anastomosis with diverting ileostomy in patients with acute diverticulitis requiring urgent operative intervention. Dis Colon Rectum 2018; 61: 586–592. [Link]

Abstract

Barrett’s oesophagus is a premalignant condition of the distal oesophagus predisposing to oesophageal adenocarcinoma. Given the potential for malignant progression and the poor prognosis of eosophageal adenocarcinoma when diagnosed at a symptomatic stage, patients with known Barrett oesophagus undergo regular endoscopic surveillance to detect neoplastic progression at an early and preferably endoscopically, treatable stage. Endoscopic management of early Barrett oesophagus neoplasia consists of a combination of endoscopic imaging, endoscopic resection and endoscopic ablation. Below we discuss a number of mistakes that are frequently made when managing Barrett oesophagus neoplasia and how to avoid them. Much of this discussion draws on existing guidelines (for background reading, check the ESGE Barrett oesophagus guideline), but in many instances the underlying evidence (even in the guideline) is missing and therefore many of our practically driven recommendations are based on common sense and our experience in this field.


Topics

Oesophagus

Citation

Verheij EPD, Pouw RE and Bergman JJ. Mistakes in endoscopic treatment of Barrett oesophagus neoplasia and how to avoid them. UEG Education 2021; 21: 35–39.

Published

2021

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Weight loss "Endoscopy vs. Surgery" with Ivo Boskoski and Ralph Peterli

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Abstract

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Endoscopy Surgery

Published

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Mistakes in liver transplantation and how to avoid them

Alberto Zanetto, Patrizia Burra

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References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Painter NS. Diverticular disease of the colon. Br Med J 1968; 3: 475–479. [Link]
2.
Stollman N and Raskin JB. Diverticular disease of the colon. Lancet 2004; 363: 631–639. [Link]
3.
Hinchey EJ, et al. Treatment of perforated diverticular disease of the colon. Adv Surg 1978; 12: 85–109. [Link]
4.
Wasvary H, et al. Same hospitalization resection for acute diverticulitis. Am Surg 1999; 65: 632–635. [Link]
5.
Burkitt DP, et al. Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease. Lancet 1972; 2: 1408–1412. [Link]
6.
Stam MA, et al. An unrestricted diet for uncomplicated diverticulitis is safe: results of a prospective diverticulitis diet study. Colorectal Dis 2017; 19: 372–377. [Link]
7.
van de Wall BJ, et al. Dietary restrictions for acute diverticulitis: evidence-based or expert opinion? Int J Colorectal Dis 2013; 28: 1287–1293. [Link]
8.
Rottier SJ, et al. Complicated disease course in initially computed tomography-proven uncomplicated acute diverticulitis. Surg Infect (Larchmt) Epub ahead of print (August 14 2019). doi: 10.1089/sur.2018.289. [Link]
9.
Gregersen R, et al. Treatment of patients with acute colonic diverticulitis complicated by abscess formation: A systematic review. Int J Surg 2016; 35: 201–208. [Link]
10.
Lambrichts DPV, et al. Multicentre study of non-surgical management of diverticulitis with abscess formation. Br J Surg 2019; 106: 458–466. [Link]
11.
Nielsen K, et al. The limited role of ultrasound in the diagnostic process of colonic diverticulitis. World J Surg 2014; 38: 1814–1818. [Link]
12.
Lameris W, et al. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol 2008; 18: 2498–2511. [Link]
13.
van Randen A, et al. A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain. Eur Radiol 2011; 21: 1535–1545. [Link]
14.
Bridoux V, et al. Elective operation after acute complicated diverticulitis: is it still mandatory? World J Gastroenterol 2014; 20: 8166–8172. [Link]
15.
Sallinen VJ, et al. Nonoperative management of perforated diverticulitis with extraluminal air is safe and effective in selected patients. Dis Colon Rectum 2014; 57: 875–881. [Link]
16.
van Dijk ST, et al. A systematic review of pericolic extraluminal air in left-sided acute colonic diverticulitis. Surg Infect (Larchmt) 2018; 19: 362–368. [Link]
17.
Colas PA, et al. Failure of conservative treatment of acute diverticulitis with extradigestive air. World J Surg 2017; 41: 1890–1895. [Link]
18.
Daniels L, et al. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. Br J Surg 2017; 104: 52–61. [Link]
19.
Chabok A, et al. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012; 99: 532–539. [Link]
20.
van Dijk ST, et al. Long-term effects of omitting antibiotics in uncomplicated acute diverticulitis. Am J Gastroenterol 2018; 113: 1045–1052. [Link]
21.
van Dijk ST, et al. A systematic review and meta-analysis of outpatient treatment for acute diverticulitis. Int J Colorectal Dis 2018; 33: 505–512. [Link]
22.
de Boer MGJ, et al. The Dutch national guideline ‘Acute Diverticulitis’, https://richtlijnendatabase.nl/richtlijn/acute_diverticulitis/startpagina_-_acute_diverticulitis.html#verantwoording (2018, accessed 28 November 2019 ; in Dutch). [Link]
23.
Andersen JC, et al. Danish national guidelines for treatment of diverticular disease. Dan Med J 2012; 59: C4453. [Link]
24.
Binda GA, et al. Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines. Tech Coloproctol 2015; 19: 615–626. [Link]
25.
Feingold D, et al. Practice parameters for the treatment of sigmoid diverticulitis. Dis Colon Rectum 2014; 57: 284–294. [Link]
26.
Kruis W, et al. Diverticular disease: Guidelines of the German Society for Gastroenterology, Digestive and Metabolic Diseases and the German Society for General and Visceral Surgery. Digestion 2014; 90: 190–207. [Link]
27.
Stollman N, et al. American Gastroenterological Association Institute guideline on the management of acute diverticulitis. Gastroenterology 2015; 149: 1944–1949. [Link]
28.
Wilkins T, et al. Diagnosis and management of acute diverticulitis. Am Fam Physician 2013; 87: 612–620. [Link]
29.
Rottier SJ, et al. Meta-analysis of the role of colonoscopy after an episode of left-sided acute diverticulitis. Br J Surg 2019; 106: 988–997. [Link]
30.
Binda GA, et al. Primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a prematurely terminated randomized controlled trial. Colorectal Dis 2012; 14: 1403–1410. [Link]
31.
Bridoux V, et al. Hartmann's procedure or primary anastomosis for generalized peritonitis due to perforated diverticulitis: a prospective multicenter randomized trial (DIVERTI). J Am Coll Surg 2017; 225: 798–805. [Link]
32.
Oberkofler CE, et al. A multicenter randomized clinical trial of primary anastomosis or Hartmann's procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg 2012; 256: 819–826. [Link]
33.
Lambrichts DPV, et al. Hartmann's procedure versus sigmoidectomy with primary anastomosis for perforated diverticulitis with purulent or faecal peritonitis (LADIES): a multicentre, parallel-group, randomised, open-label, superiority trial. Lancet Gastroenterol Hepatol 2019; 4: 599–610. [Link]
34.
Cauley CE, et al. Use of primary anastomosis with diverting ileostomy in patients with acute diverticulitis requiring urgent operative intervention. Dis Colon Rectum 2018; 61: 586–592. [Link]

Abstract

Topics

Hepatobiliary Surgery

Citation

Burra P and Zanetto A. Mistakes in liver transplantation and how to avoid them. UEG Education 2020; 2020: 1–6.

Published

2020

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UEG Mistakes In Articles
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Mistakes in gastrostomy insertion in children and adolescents and how to avoid them

Christos Tzivinikos, Ilse Broekaert, Jorge Amil Dias, Matjaz Homan

Summary

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Summary is not available for this content yet.

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References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Painter NS. Diverticular disease of the colon. Br Med J 1968; 3: 475–479. [Link]
2.
Stollman N and Raskin JB. Diverticular disease of the colon. Lancet 2004; 363: 631–639. [Link]
3.
Hinchey EJ, et al. Treatment of perforated diverticular disease of the colon. Adv Surg 1978; 12: 85–109. [Link]
4.
Wasvary H, et al. Same hospitalization resection for acute diverticulitis. Am Surg 1999; 65: 632–635. [Link]
5.
Burkitt DP, et al. Effect of dietary fibre on stools and the transit-times, and its role in the causation of disease. Lancet 1972; 2: 1408–1412. [Link]
6.
Stam MA, et al. An unrestricted diet for uncomplicated diverticulitis is safe: results of a prospective diverticulitis diet study. Colorectal Dis 2017; 19: 372–377. [Link]
7.
van de Wall BJ, et al. Dietary restrictions for acute diverticulitis: evidence-based or expert opinion? Int J Colorectal Dis 2013; 28: 1287–1293. [Link]
8.
Rottier SJ, et al. Complicated disease course in initially computed tomography-proven uncomplicated acute diverticulitis. Surg Infect (Larchmt) Epub ahead of print (August 14 2019). doi: 10.1089/sur.2018.289. [Link]
9.
Gregersen R, et al. Treatment of patients with acute colonic diverticulitis complicated by abscess formation: A systematic review. Int J Surg 2016; 35: 201–208. [Link]
10.
Lambrichts DPV, et al. Multicentre study of non-surgical management of diverticulitis with abscess formation. Br J Surg 2019; 106: 458–466. [Link]
11.
Nielsen K, et al. The limited role of ultrasound in the diagnostic process of colonic diverticulitis. World J Surg 2014; 38: 1814–1818. [Link]
12.
Lameris W, et al. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol 2008; 18: 2498–2511. [Link]
13.
van Randen A, et al. A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain. Eur Radiol 2011; 21: 1535–1545. [Link]
14.
Bridoux V, et al. Elective operation after acute complicated diverticulitis: is it still mandatory? World J Gastroenterol 2014; 20: 8166–8172. [Link]
15.
Sallinen VJ, et al. Nonoperative management of perforated diverticulitis with extraluminal air is safe and effective in selected patients. Dis Colon Rectum 2014; 57: 875–881. [Link]
16.
van Dijk ST, et al. A systematic review of pericolic extraluminal air in left-sided acute colonic diverticulitis. Surg Infect (Larchmt) 2018; 19: 362–368. [Link]
17.
Colas PA, et al. Failure of conservative treatment of acute diverticulitis with extradigestive air. World J Surg 2017; 41: 1890–1895. [Link]
18.
Daniels L, et al. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis. Br J Surg 2017; 104: 52–61. [Link]
19.
Chabok A, et al. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg. 2012; 99: 532–539. [Link]
20.
van Dijk ST, et al. Long-term effects of omitting antibiotics in uncomplicated acute diverticulitis. Am J Gastroenterol 2018; 113: 1045–1052. [Link]
21.
van Dijk ST, et al. A systematic review and meta-analysis of outpatient treatment for acute diverticulitis. Int J Colorectal Dis 2018; 33: 505–512. [Link]
22.
de Boer MGJ, et al. The Dutch national guideline ‘Acute Diverticulitis’, https://richtlijnendatabase.nl/richtlijn/acute_diverticulitis/startpagina_-_acute_diverticulitis.html#verantwoording (2018, accessed 28 November 2019 ; in Dutch). [Link]
23.
Andersen JC, et al. Danish national guidelines for treatment of diverticular disease. Dan Med J 2012; 59: C4453. [Link]
24.
Binda GA, et al. Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines. Tech Coloproctol 2015; 19: 615–626. [Link]
25.
Feingold D, et al. Practice parameters for the treatment of sigmoid diverticulitis. Dis Colon Rectum 2014; 57: 284–294. [Link]
26.
Kruis W, et al. Diverticular disease: Guidelines of the German Society for Gastroenterology, Digestive and Metabolic Diseases and the German Society for General and Visceral Surgery. Digestion 2014; 90: 190–207. [Link]
27.
Stollman N, et al. American Gastroenterological Association Institute guideline on the management of acute diverticulitis. Gastroenterology 2015; 149: 1944–1949. [Link]
28.
Wilkins T, et al. Diagnosis and management of acute diverticulitis. Am Fam Physician 2013; 87: 612–620. [Link]
29.
Rottier SJ, et al. Meta-analysis of the role of colonoscopy after an episode of left-sided acute diverticulitis. Br J Surg 2019; 106: 988–997. [Link]
30.
Binda GA, et al. Primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a prematurely terminated randomized controlled trial. Colorectal Dis 2012; 14: 1403–1410. [Link]
31.
Bridoux V, et al. Hartmann's procedure or primary anastomosis for generalized peritonitis due to perforated diverticulitis: a prospective multicenter randomized trial (DIVERTI). J Am Coll Surg 2017; 225: 798–805. [Link]
32.
Oberkofler CE, et al. A multicenter randomized clinical trial of primary anastomosis or Hartmann's procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis. Ann Surg 2012; 256: 819–826. [Link]
33.
Lambrichts DPV, et al. Hartmann's procedure versus sigmoidectomy with primary anastomosis for perforated diverticulitis with purulent or faecal peritonitis (LADIES): a multicentre, parallel-group, randomised, open-label, superiority trial. Lancet Gastroenterol Hepatol 2019; 4: 599–610. [Link]
34.
Cauley CE, et al. Use of primary anastomosis with diverting ileostomy in patients with acute diverticulitis requiring urgent operative intervention. Dis Colon Rectum 2018; 61: 586–592. [Link]

Abstract

Adequate nutrition is essential for the homeostasis of fluids and nutrients, growth and thriving, especially in children. While the underlying principle of percutaneous endoscopic gastrostomy (PEG) placement is the same for both adults and children—providing a means of enteral feeding through the stomach—the indications, considerations and techniques differ owing to anatomical differences, age-dependent physiological concerns, and the age- and disease-specific needs of the child.

If feeding via nasogastric tube (NGT) or naso-jejunal tube (NJT) is necessary for a prolonged time, placement of a PEG or percutaneous endoscopic gastro-jejunal (PEG-J) tube should be considered. A PEG tube also allows the delivery of medications and venting of the stomach when needed. Nutrition via PEG facilitates the transition to out-of-hospital care and improves the quality of life (QoL) for children and families while improving the outcome of children with chronic diseases.

There are recent clinical guidelines providing guidance for PEG tube placement in children, but little advice on, e.g., choosing the right device for the right patient, details on postoperative management, removal of the PEG tube and other specific cases. The following article provides a combination of evidence-based data and the authors’ clinical experience.

Topics

Paediatrics Small Intestine & Nutrition Stomach & H. Pylori

Citation

Broekaert I.J, Dias J.A, Homan M and Tzivinikos C. Mistakes in gastrostomy insertion in children and adolescents and how to avoid them. UEG Education 2024; 24: 34-38.

Published

2024

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