{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T11:11:29Z","timestamp":1698318689202},"reference-count":49,"publisher":"Akademiai Kiado Zrt.","issue":"16","license":[{"start":{"date-parts":[[2022,4,17]],"date-time":"2022-04-17T00:00:00Z","timestamp":1650153600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2022,4,17]]},"abstract":"<jats:p><jats:bold>\u00d6sszefoglal\u00f3.<\/jats:bold> A vastagb\u00e9l-diverticulosis el\u0151fordul\u00e1si gyakoris\u00e1ga\n                    vil\u00e1gszerte n\u00f6vekszik, aminek h\u00e1tter\u00e9ben els\u0151sorban di\u00e9t\u00e1s \u00e9s \u00e9letm\u00f3dbeli\n                    v\u00e1ltoz\u00e1sok \u00e1llnak. Az esetek jelent\u0151s h\u00e1nyad\u00e1ban a vastagb\u00e9l-diverticulosis\n                    semmif\u00e9le panaszt nem okoz, v\u00e9letlen\u00fcl fedezik fel, \u00edgy kezel\u00e9st sem ig\u00e9nyel.\n                    T\u00fcnetek az esetek mintegy 25%-\u00e1ban jelentkeznek: ez az \u00fan. diverticularis\n                    betegs\u00e9g, melynek k\u00fcl\u00f6nb\u00f6z\u0151 s\u00falyoss\u00e1g\u00fa \u00e9s lefoly\u00e1s\u00fa form\u00e1i ismertek. A 2000-es\n                    \u00e9vek elej\u00e9t\u0151l a diverticulosis kialakul\u00e1s\u00e1ban szerepet j\u00e1tsz\u00f3 patofiziol\u00f3giai\n                    folyamatok \u2013 \u00fagymint a genetikai h\u00e1tt\u00e9r, az alacsony fok\u00fa kr\u00f3nikus gyullad\u00e1s \u00e9s\n                    a b\u00e9ldysbiosis jelenl\u00e9te \u2013 jobb meg\u00e9rt\u00e9se el\u0151seg\u00edtette a megel\u0151z\u00e9s, a\n                    diagnosztika \u00e9s a kezel\u00e9s eszk\u00f6zeinek fejl\u0151d\u00e9s\u00e9t. F\u0151bb meg\u00e1llap\u00edt\u00e1sok: A\n                    t\u00fcneteket okoz\u00f3 sz\u00f6v\u0151dm\u00e9nymentes diverticulosis elk\u00fcl\u00f6n\u00edt\u00e9se az\n                    irrit\u00e1bilisb\u00e9l-szindr\u00f3m\u00e1t\u00f3l egy\u00e9rtelm\u0171en kih\u00edv\u00e1st jelent. Az akut diverticulitis\n                    el\u0151fordul\u00e1si gyakoris\u00e1ga alacsonyabb, mint kor\u00e1bban felt\u00e9telezt\u00e9k. A\n                    k\u00e9palkot\u00f3knak, k\u00fcl\u00f6n\u00f6sen a hasi komputertomogr\u00e1fi\u00e1nak a szerepe el\u0151t\u00e9rbe ker\u00fclt\n                    a gyors \u00e9s megfelel\u0151 diagn\u00f3zis fel\u00e1ll\u00edt\u00e1s\u00e1ban \u00e9s a betegs\u00e9g s\u00falyoss\u00e1g\u00e1nak\n                    meghat\u00e1roz\u00e1s\u00e1ban. A magas rosttartalm\u00fa \u00e9trend az eg\u00e9szs\u00e9ges t\u00e1pl\u00e1lkoz\u00e1s fontos\n                    r\u00e9sze, ugyanakkor nincs bizony\u00edt\u00e9k arra, hogy gyors\u00edtan\u00e1 az akut diverticulitis\n                    sor\u00e1n a felgy\u00f3gyul\u00e1st, vagy megel\u0151zn\u00e9 annak ki\u00fajul\u00e1s\u00e1t. \u00dajabban vitatj\u00e1k azt a\n                    hagyom\u00e1nyos \u00e1ll\u00e1spontot, miszerint a sz\u00f6v\u0151dm\u00e9nymentes akut diverticulitist\n                    mindenk\u00e9ppen antibiotikummal kell kezelni, \u00e9s k\u00f3rh\u00e1zi felv\u00e9telt ig\u00e9nyel. Akut\n                    diverticulitis eset\u00e9n nem aj\u00e1nlott kolonoszk\u00f3pia v\u00e9gz\u00e9se a perfor\u00e1ci\u00f3vesz\u00e9ly\n                    miatt. Elekt\u00edv kolonoszk\u00f3pia 6 h\u00e9ttel k\u00e9s\u0151bb javasolt, colorectalis carcinoma\n                    kiz\u00e1r\u00e1s\u00e1ra, amennyiben 3 \u00e9ven bel\u00fcl nem ker\u00fclt r\u00e1 sor. Bizonyos esetekben a\n                    rutinkolonoszk\u00f3pia azonban el is hagyhat\u00f3. A sz\u00f6v\u0151dm\u00e9nyes akut diverticulitis\n                    kezel\u00e9se sor\u00e1n nem mindig sz\u00fcks\u00e9ges s\u00fcrg\u0151s seb\u00e9szeti beavatkoz\u00e1s. A m\u0171t\u00e9tre\n                    szorul\u00f3, hemodinamikailag stabil, immunkompetens betegekben\n                    diverticulumperfor\u00e1ci\u00f3 \u00e9s diff\u00faz peritonitis eset\u00e9n pedig a reszekci\u00f3 \u00e9s a\n                    primer anasztom\u00f3zisk\u00e9sz\u00edt\u00e9s egyre ink\u00e1bb teret nyer a Hartmann-m\u0171t\u00e9ttel szemben.\n                    A szerz\u0151k a jelen \u00f6sszefoglal\u00f3val a diverticulosis korszer\u0171, egy\u00e9nre szabott\n                    ell\u00e1t\u00e1s\u00e1t k\u00edv\u00e1nj\u00e1k el\u0151seg\u00edteni a mindennapi klinikai gyakorlatban. Orv Hetil.\n                    2022; 163(16): 614\u2013623.<\/jats:p>\n                <jats:p><jats:bold>Summary.<\/jats:bold> The prevalence of colonic diverticulosis is growing\n                    worldwide due to dietary and lifestyle changes. Colonic diverticulosis does not\n                    cause any complaints in a significant proportion of individuals; therefore, it\n                    is usually diagnosed by accident and does not require any treatment.\n                    Diverticular disease, which constitutes about 25% of the cases, is associated\n                    with presenting symptoms, and has various forms based on the course and severity\n                    of the disease. From the early 2000s, the better understanding of the\n                    pathophysiologic pathways which play a role in the development of the\n                    diverticular disease (genetic background, low-grade chronic inflammation and\n                    intestinal dysbiosis) promoted prevention, diagnostics and finding treatment\n                    options. The main conclusions: It is a challenge to distinguish uncomplicated\n                    but symptomatic diverticular disease from irritable bowel syndrome. The\n                    prevalence of acute diverticulitis is lower than it was previously assumed. The\n                    role of diagnostic imaging, mainly abdominal computer tomography, has become\n                    more important to aid the rapid and correct diagnosis of acute diverticulitis\n                    and to determine its severity. Although a high-fiber diet may be recommended for\n                    general health purposes, there is little evidence that it benefits recovery\n                    during acute diverticulitis episodes or prevents recurrent episodes. Traditional\n                    antibiotic therapy as the mainstay of treatment of acute uncomplicated\n                    diverticulitis such as routine hospital admission has been challenged recently.\n                    In an acute episode of diverticulitis, performing colonoscopy should be avoided\n                    as it is associated with an increased risk of colonic perforation. If there was\n                    no screening colonoscopy within 3 years, it is strongly recommended at least 6\n                    weeks after the acute episode to exclude colorectal carcinoma. Routine\n                    colonoscopy may be omitted in certain cases. Complicated acute diverticulitis\n                    should not necessarily be treated by emergency surgery. In the case of\n                    hemodynamically stable and immunocompetent patients, resection with primary\n                    anastomosis may be preferred over a Hartmann\u2019s procedure for the treatment of\n                    perforated diverticulitis and diffuse peritonitis. With this review, the authors\n                    intend to facilitate providing up-to-date and customized treatment of\n                    diverticular disease in the daily practice. Orv Hetil. 2022; 163(16):\n                    614\u2013623.<\/jats:p>","DOI":"10.1556\/650.2022.32420","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T22:14:30Z","timestamp":1668809670000},"page":"614-623","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":0,"title":["A vastagb\u00e9l-diverticulosis vesz\u00e9lyei \u00e9s kezel\u00e9se."],"prefix":"10.1556","volume":"163","author":[{"given":"Tam\u00e1s","family":"Bub\u00e1n","sequence":"first","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Gasztroenterol\u00f3giai Klinika Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00f3ra","family":"Sipeki","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Gasztroenterol\u00f3giai Klinika Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Csaba","family":"V\u00e1rv\u00f6lgyi","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Gasztroenterol\u00f3giai Klinika Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e1ria","family":"Papp","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Klinikai K\u00f6zpont, Gasztroenterol\u00f3giai Klinika Debrecen, Nagyerdei krt. 98., 4032 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref0","doi-asserted-by":"publisher","first-page":"125","DOI":"10.5009\/gnl16552","article-title":"Diverticular disease: an update on pathogenesis and management","volume":"12","author":"1 Rezapour","year":"2018","unstructured":"1 Rezapour M, Ali S, Stollman N. 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