{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T23:06:18Z","timestamp":1724713578269},"reference-count":13,"publisher":"Akademiai Kiado Zrt.","issue":"4","content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["MaSeb"],"published-print":{"date-parts":[[2021,11,25]]},"abstract":"\u00d6sszefoglal\u00f3.<\/jats:bold>\n Bevezet\u00e9s:<\/jats:italic> A colon sigmoideum diverticulosisa velesz\u00fcletett\n vagy szerzett lehet. Az \u00f3ri\u00e1s vastagb\u00e9l diverticulum (Giant Colonic\n Diverticulum, GCD), amelyet 4 cm-n\u00e9l nagyobb diverticulumk\u00e9nt defini\u00e1lnak,\n ritka, de klinikailag fontos entit\u00e1s. A McNutt (1988) oszt\u00e1lyoz\u00e1st haszn\u00e1lj\u00e1k az\n \u00f3ri\u00e1s diverticulumok h\u00e1rom alcsoportj\u00e1nak megk\u00fcl\u00f6nb\u00f6ztet\u00e9s\u00e9re. Az 1-es t\u00edpus\u00fa\n diverticulumok pulzi\u00f3s pseudo-diverticulumok, amelyek fokozatosan n\u00f6vekszenek. A\n 2-es t\u00edpus\u00fa diverticulumok gyullad\u00e1sos eredet\u0171ek; egy kor\u00e1bbi suberosalis\n perfor\u00e1ci\u00f3 ut\u00e1n alakulnak ki, ahol a t\u00e1lyog\u00fcreg kommunik\u00e1l a b\u00e9l lumen\u00e9vel, \u00e9s a\n t\u00e1lyogfal fokozatosan rostony\u00e1s hegsz\u00f6vett\u00e9 alakul, melyb\u0151l hi\u00e1nyoznak a b\u00e9l\n sz\u00f6vettani r\u00e9tegei. A 3. t\u00edpus a vastagb\u00e9l val\u00f3di, velesz\u00fcletett diverticulumai,\n amelyek a b\u00e9lfal minden r\u00e9teg\u00e9t tartalmazz\u00e1k.<\/jats:p>\n Egy 59 \u00e9ves f\u00e9rfibeteg eset\u00e9t ismertetj\u00fck, akit s\u00fcrg\u0151ss\u00e9ggel vett\u00fcnk fel\n Seb\u00e9szeti Oszt\u00e1lyunkra kiz\u00e1r\u00f3dott bal oldali l\u00e1gy\u00e9ks\u00e9rv diagn\u00f3zissal. Hasi\n CT-vizsg\u00e1lat a s\u00e9rvt\u00f6ml\u0151ben herni\u00e1l\u00f3dott sigmab\u00e9l-szakaszt \u00e1br\u00e1zolt,\n b\u00e9lelz\u00e1r\u00f3d\u00e1s jelei n\u00e9lk\u00fcl. S\u00fcrg\u0151s m\u0171t\u00e9tet v\u00e9gezt\u00fcnk; bal oldali inguinalis\n metsz\u00e9st k\u00f6vet\u0151en a s\u00e9rvt\u00f6ml\u0151ben a sigmab\u00e9l 3-as t\u00edpus\u00fa \u00f3ri\u00e1s diverticulum\u00e1t\n tal\u00e1ltuk. Laparot\u00f3mi\u00e1t v\u00e9gezt\u00fcnk, \u00e9s egy szokatlanul nagy, 7-8 cm hossz\u00fa\n incarcer\u00e1l\u00f3dott diverticulumot szabad\u00edtottunk fel. Egy\u00e9b k\u00f3ros nem volt a\n has\u00fcregben, a sigmab\u00e9l nem k\u00e1rosodott. A diverticulumot TA varr\u00f3g\u00e9ppel\n resec\u00e1ltuk, a kapocssort seromuscularis varrattal buktattuk. A s\u00e9rvkaput\n k\u00edv\u00fclr\u0151l z\u00e1rtuk. A postoperat\u00edv szak esem\u00e9nytelen volt, a beteget a 7. napon\n otthon\u00e1ba bocs\u00e1tottuk.<\/jats:p>\n R\u00f6viden \u00e1ttekintj\u00fck a GCD diagn\u00f3zis\u00e1ra \u00e9s kezel\u00e9s\u00e9re vonatkoz\u00f3 aj\u00e1nl\u00e1sokat. Az\n elv\u00e1ltoz\u00e1s McNutt 3-as t\u00edpusa miatt a kev\u00e9sb\u00e9 invaz\u00edv, egyszer\u0171\n diverticulectomi\u00e1t v\u00e1lasztottuk a (Hartmann-szerinti) sigmaresectio helyett.\n Eset\u00fcnk az am\u00fagy is kis sz\u00e1mban el\u0151fordul\u00f3 GCD rendk\u00edv\u00fcl ritka sz\u00f6v\u0151dm\u00e9nye volt,\n amit egy szokatlan \u2013 de sikeres gy\u00f3gyul\u00e1st eredm\u00e9nyez\u0151 \u2013 beavatkoz\u00e1ssal\n oldottunk meg.<\/jats:p>\n Summary.<\/jats:bold>\n Introduction:<\/jats:italic> The diverticulosis of the sigmoid colon may be\n congenital or acquired. The Giant Colonic Diverticulum (GCD), defined as a\n diverticulum larger than 4 cm, is a rare, but clinically important entity. The\n McNutt (1988) classification is used differentiate the three subgroups of giant\n diverticula. Type 1 diverticula are pulsion pseudo-diverticula, which enlarge\n gradually. Type 2 are inflammatory diverticula due to a previous subserosal\n perforation, where the abscess cavity is communicating with the bowel lumen and\n its wall would be gradually composed of fibrous scar tissue, lacking the\n intestinal histological layers. Type 3 are the real, congenital diverticula of\n the colon, containing all layers of the intestinal wall.<\/jats:p>\n We present a case of a 59-year-old male patient, who was admitted to our Dept. of\n Surgery in emergency with the diagnosis of strangulated left inguinal hernia.\n Abdominal CT demonstrated the herniation of the sigmoid colon into the hernia\n sac without the signs of bowel obstruction. The patient was operated on\n urgently; subsequent to a left inguinal incision, a Type 3 giant diverticulum of\n the sigmoid colon was found in the hernia sac. Laparotomy was performed, and the\n unusually large, 7-8 cm long strangulated diverticulum was liberated. There were\n no other pathological findings, the sigmoid colon was not damaged. The\n diverticulum was resected with a TA stapler, and the staple line was inverted\n with a layer of seromuscular sutures. The inguinal hernia orifices were\n reconstructed both intraabdominally and externally. The postoperative course was\n uneventful, the patient was discharged on the 7th day.<\/jats:p>\n The recommendations concerning the diagnosis and treatment GCD are briefly\n reviewed. Due to the McNutt Type 3 characteristics, we opted for the less\n invasive, simple diverticulectomy instead of sigmoid resection (Hartmann\u2019s\n procedure). Our case was an extremely rare complication of the already uncommon\n GCD, resolved by an unusual surgical intervention leading to a successful\n cure.<\/jats:p>","DOI":"10.1556\/1046.74.2021.4.3","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T09:30:47Z","timestamp":1673343047000},"page":"117-121","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":1,"title":["L\u00e1gy\u00e9ks\u00e9rvbe kiz\u00e1r\u00f3dott \u00f3ri\u00e1s sigmab\u00e9l diverticulum"],"prefix":"10.1556","volume":"74","author":[{"given":"Art\u00far","family":"Seli","sequence":"first","affiliation":[{"name":"D\u00e9l-pesti Centrumk\u00f3rh\u00e1z \u2013 Orsz\u00e1gos Hematol\u00f3giai \u00e9s Infektol\u00f3giai Int\u00e9zet \u2013 Szent Istv\u00e1n Telephely, Seb\u00e9szeti Oszt\u00e1ly, 1097 Budapest, Nagyv\u00e1rad t\u00e9r 1."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e9za","family":"Telek","sequence":"additional","affiliation":[{"name":"D\u00e9l-pesti Centrumk\u00f3rh\u00e1z \u2013 Orsz\u00e1gos Hematol\u00f3giai \u00e9s Infektol\u00f3giai Int\u00e9zet \u2013 Szent Istv\u00e1n Telephely, Seb\u00e9szeti Oszt\u00e1ly, 1097 Budapest, Nagyv\u00e1rad t\u00e9r 1."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edit","family":"Babarczi","sequence":"additional","affiliation":[{"name":"D\u00e9l-pesti Centrumk\u00f3rh\u00e1z \u2013 Orsz\u00e1gos Hematol\u00f3giai \u00e9s Infektol\u00f3giai Int\u00e9zet \u2013 Szent Istv\u00e1n Telephely, Patol\u00f3gia, Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tibor","family":"Rudisch","sequence":"additional","affiliation":[{"name":"D\u00e9l-pesti Centrumk\u00f3rh\u00e1z \u2013 Orsz\u00e1gos Hematol\u00f3giai \u00e9s Infektol\u00f3giai Int\u00e9zet \u2013 Szent Istv\u00e1n Telephely, Radiol\u00f3gia, Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bal\u00e1zs","family":"Vir\u00e1g","sequence":"additional","affiliation":[{"name":"D\u00e9l-pesti Centrumk\u00f3rh\u00e1z \u2013 Orsz\u00e1gos Hematol\u00f3giai \u00e9s Infektol\u00f3giai Int\u00e9zet \u2013 Szent Istv\u00e1n Telephely, Seb\u00e9szeti Oszt\u00e1ly, 1097 Budapest, Nagyv\u00e1rad t\u00e9r 1."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanni","family":"F\u00fcl\u00f6p","sequence":"additional","affiliation":[{"name":"D\u00e9l-pesti Centrumk\u00f3rh\u00e1z \u2013 Orsz\u00e1gos Hematol\u00f3giai \u00e9s Infektol\u00f3giai Int\u00e9zet \u2013 Szent Istv\u00e1n Telephely, Seb\u00e9szeti Oszt\u00e1ly, 1097 Budapest, Nagyv\u00e1rad t\u00e9r 1."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f3zsef","family":"S\u00e1ndor","sequence":"additional","affiliation":[{"name":"D\u00e9l-pesti Centrumk\u00f3rh\u00e1z \u2013 Orsz\u00e1gos Hematol\u00f3giai \u00e9s Infektol\u00f3giai Int\u00e9zet \u2013 Szent Istv\u00e1n Telephely, Seb\u00e9szeti Oszt\u00e1ly, 1097 Budapest, Nagyv\u00e1rad t\u00e9r 1."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferenc","family":"Ender","sequence":"additional","affiliation":[{"name":"D\u00e9l-pesti Centrumk\u00f3rh\u00e1z \u2013 Orsz\u00e1gos Hematol\u00f3giai \u00e9s Infektol\u00f3giai Int\u00e9zet \u2013 Szent Istv\u00e1n Telephely, Seb\u00e9szeti Oszt\u00e1ly, 1097 Budapest, Nagyv\u00e1rad t\u00e9r 1."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref0","unstructured":"1 Lonovics J, Nemes\u00e1nszky E, Simon L, Tulassay Zs, Wittmann T. (szerk.): Varr\u00f3 Gasztroenterol\u00f3gia. Medicina Kiad\u00f3. 2011; 405."},{"key":"ref1","unstructured":"2 Bonvin MMP, Bonte G: Diverticules giants due sigmoide. Arch Mal Appar Dig Mal Nutr. 1946; 35: 353-355."},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"3 Steenvoorde P, Vogelaar FJ, Oskam J, Tollenaar RA: Giant colonic diverticula. Review of diagnostic and therapeutic options. Dig Surg. 2004; 21(1): 1-6.","DOI":"10.1159\/000074833"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"4 Nigri G, Petrucciani N, Giannini G, Aurello P, Magistri P, Gasparrini M, Ramacciato G: Giant colonic diverticulum, clinical presentation, diagnosis and treatment: Systematic review of 166 cases. World J Gastroenterol. 2015; 21: 360-368.","DOI":"10.3748\/wjg.v21.i1.360"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"5 Naing T, Ray S, Loughran CF: Giant sigmoid diverticulum: a report of three cases. Clin Radiol. 1999; 54: 179-181.","DOI":"10.1016\/S0009-9260(99)91011-5"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1007\/BF02556799","article-title":"Report of a case","volume":"31","author":"6 McNutt","year":"1988","unstructured":"6 McNutt R, Schmitt D, Schulte W: Giant colonic diverticula-three distinct entities. Report of a case. Dis Colon Rectum 1988; 31: 624-628.","journal-title":"Dis Colon Rectum"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"7 Chino JR, Rayhrer CS, Barrows BD, Salehpour MM: Surgical management of giant colonic diverticulum presenting after laparoscopic lavage for diverticular perforation and sepsis. Am J Case Rep. 2020; 21: e923457-1-e9234575.","DOI":"10.12659\/AJCR.923457"},{"key":"ref7","unstructured":"8 N\u00e9meth AM, Ender F, Banai J: Diverticulosis, diverticulitis. T\u00fcnettan, diagnosztika, kezel\u00e9s. LAM 2004; 14: 761-767."},{"key":"ref8","unstructured":"9 Ender F: A vastagb\u00e9l-diverticulosis seb\u00e9szi kezel\u00e9s\u00e9nek lehet\u0151s\u00e9gei. Magyar Orvos 2009; 12: 44-46."},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"10 Kam JC, Doraiswamy V, Spira RS: A rare case presentation of a perforated giant sigmoid diverticulum. Case Rep Med. 2013; 2013: 957152.","DOI":"10.1155\/2013\/957152"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"11 Collin JE, Atwal GS, Dunn WK, Acheson AG: Laparoscopic-assisted resection of a giant colonic diverticulum: a case report. J Med Case Rep. 2009; 3: 7075.","DOI":"10.1186\/1752-1947-3-7075"},{"key":"ref11","unstructured":"12 Andrabi SI, Pitale A, El-Hakeem AA: Diverticular abscess presenting as a strangulated inguinal hernia: case report and review of the literature. Ulster Med J. 2007; 76: 107-108."},{"key":"ref12","unstructured":"13 Park WC, Lee JK, Yoon SE, Yun KJ: Giant transverse colon diverticulitis presenting as indirect right inguinal hernia strangulation. Journal of the Korean Society of Coloproctology 2006; 22: 200-203."}],"container-title":["Magyar Seb\u00e9szet (Hungarian Journal of Surgery)"],"original-title":[],"link":[{"URL":"https:\/\/akjournals.com\/view\/journals\/1046\/74\/4\/article-p117.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/1046\/74\/4\/article-p117.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/1046\/74\/4\/article-p117.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T14:30:13Z","timestamp":1722868213000},"score":1,"resource":{"primary":{"URL":"https:\/\/akjournals.com\/view\/journals\/1046\/74\/4\/article-p117.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,25]]},"references-count":13,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.1556\/1046.74.2021.4.3","relation":{},"ISSN":["0025-0295","1789-4301"],"issn-type":[{"type":"print","value":"0025-0295"},{"type":"electronic","value":"1789-4301"}],"subject":[],"published":{"date-parts":[[2021,11,25]]}}}