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Foreign bodies in sigmoid colon diverticulosis
Ellen Ross1, Patricia McKenna1, John H Anderson2
1Department of Surgery, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK.
Clinical Journal of Gastroenterology
|October 15, 2017
Summary
Foreign bodies in sigmoid diverticular disease can cause serious complications. Management depends on the consequence, with colonoscopic retrieval often effective for inflammation.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Medical Device Technology
Background:
- Sigmoid colon diverticular disease is common, and foreign bodies can complicate its course.
- Foreign bodies within diverticula may lead to inflammation, perforation, abscess, or fistula formation.
- Diagnosis is typically achieved via CT scan, guiding treatment decisions.
Observation:
- A review of 40 publications identified 50 subjects with foreign bodies in sigmoid diverticular disease.
- Two novel cases highlight management strategies: diverticular bleeding from a chicken bone and retrieval of a retained EndoRings™ Device.
- Commonly reported foreign bodies include chicken bones, toothpicks, and biliary stents.
Findings:
- Foreign bodies in sigmoid diverticula can cause significant complications, including inflammation, perforation, abscess, and fistula.
- Treatment strategies vary based on the complication; resection is common for perforation/fistula, while conservative management with colonoscopic retrieval is suitable for inflammation.
- Chicken bones, toothpicks, and biliary stents have been associated with inflammation, perforation, and fistula, whereas fish bones exclusively caused inflammation.
Implications:
- Treatment decisions should prioritize the consequences of the foreign body over its specific nature.
- Colonoscopic foreign body retrieval is a viable and effective option for managing inflammatory complications.
- These findings offer valuable insights for clinicians managing complex cases of sigmoid diverticular disease with foreign bodies.