Obstructive uropathy secondary to sigmoid diverticulitis

Area of Science:

• Urology
• Gastroenterology
• Surgical Oncology

Background:

• Diverticulitis can lead to ureteral obstruction, a complication not frequently recognized in existing literature.
• Inflammatory processes in diverticulitis may extend to the retroperitoneum, impacting adjacent structures like the ureter.

Purpose of the Study:

• To investigate the incidence and clinical significance of ureteral obstruction in patients with diverticulitis.
• To propose diagnostic and management strategies for ureteral obstruction associated with diverticulitis.

Main Methods:

• A comprehensive literature review was conducted.
• A detailed analysis of 16 clinical cases of diverticulitis was performed.

Main Results:

• Ureteral obstruction is a more frequent complication of diverticulitis than previously reported.
• Retroperitoneal fibrotic inflammatory reactions were identified as a cause of ureteral involvement.

Conclusions:

• Preoperative urograms are advisable for patients scheduled for intestinal surgery, particularly those with suspected or confirmed diverticulitis.
• Surgical management of diverticulitis should include examination of the retroperitoneum for ureteral compromise.
• Ureterolysis may be necessary to relieve ureteral obstruction caused by fibrotic inflammatory reactions in the retroperitoneum.