Luis C. Maas

Obesity and complicated diverticular disease: is there an association?

Objective: Obesity is becoming a growing health concern in the general population. Multiple studies have linked diverticular disease to obesity. Furthermore, recent research has shown fat to be a critical element in the regulation of immunity and the inflammatory response. In this study, we sought to determine if body mass index (BMI) is associated with a higher incidence of complicated diverticulitis. Methods: A retrospective review of patients hospitalized with complicated diverticulitis between 1997 and 2006 was conducted. Medical, surgical and CT (Computed Tomography) guided interventions were evaluated in reference to age, gender, BMI and length of hospital stay (LOS). Results: Charts of 104 controls and 614 patients hospitalized with complicated diverticulitis were reviewed based on specified inclusion and exclusion criteria. There was no significant difference between groups by either gender (P = 0.066) or BMI (P = 0.648). There was a significant difference in age and LOS between three of the analyzed groups. No correlation was noted between BMI and LOS in any of the groups. Discussion: There has been increasing interest in obesity and its ramifications in all areas of medicine, including diverticular disease. Numerous studies have shown a strong correlation between acute diverticulitis and obesity, particularly in the young population. This study was undertaken to identify a possible link between complicated diverticulitis and obesity. Anecdotal reports and a few studies have found a parallel association. However, in this retrospective study, no correlation was found between BMI and the incidence of complicated diverticulitis.

Epiploic appendagitis: the great mimicker.

Epiploic appendagitis is a benign, self-limited, clinicopathological, and radiological entity that has become more commonly recognized. The clinical presentation resembles a variety of other medical and surgical intra-abdominal conditions and may easily be confused with many of them. Computed tomography (CT) demonstrates characteristic features that help make the diagnosis in most cases, thus avoiding unneeded treatment or surgery. Here, we discuss a case series of five patients who presented with abdominal pain and were ultimately diagnosed with epiploic appendagitis.

Lymphadenopathy in celiac sprue, not necessarily a malignant disease.

A 47-year-old woman who was studied for other reasons proved to have abdominal lymphadenopathy, some nodes measuring up to 2 cm. The patient, through biopsy and other studies, was diagnosed with celiac sprue; however, on a gluten-free diet, abdominal computed tomography scans several months later showed marked reduction in the size of the mesenteric nodes.