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Obstructive uropathy secondary to sigmoid diverticulitis

J M Siminovitch, V W Fazio

    Diseases of the Colon and Rectum
    |October 1, 1980
    PubMed
    Summary

    Ureteral obstruction is a more common complication of diverticulitis than previously thought. Preoperative urograms and examination for retroperitoneal fibrosis are recommended for patients undergoing intestinal surgery.

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    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.

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