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An elderly female with a history of long-standing diverticulosis presented for CT colonography. A narrowing of an area in her sigmoid colon was visualised. Also visualised was cement leakage from a percutaneous vertebroplasty (PVP) that she underwent fifteen years ago for pain relief of osteoporotic collapse of two thoracolumbar vertebrae. Images of her diverticular disease, and of cement leakage as an extracolonic finding, are presented. Literature for both findings is discussed. [ABSTRACT FROM AUTHOR]

Objective: The goal of this study was to examine the effect of the Affordable Care Act Medicaid expansion on rates of hospitalization and surgery for diverticulitis. Study Settings: Data were obtained from the Healthcare Cost and Utilization Project State Inpatient Databases from 2010 to 2014. Study Design: Retrospective cohort study analyzing adult patients undergoing surgery for diverticulitis in the expansion and nonexpansion states, pre (2010-2013) and post (2014) Medicaid expansion. Findings: There were a total of 159,419 patients in our cohort analysis. 75,575 (49%) in expansion states and 81,844 (51%) in non-expansion states. In multivariable Poisson regression, the rate of surgical procedures for diverticular disease increased among Medicaid patients (IRR 1.80; p <.01) whereas surgery rates in self-pay patients decreased (IRR 0.67; p <.01) in expansion states compared to non-expansion states. Conclusions: In states that expanded Medicaid coverage under the Affordable Care Act, the rate of surgery for diverticular disease in Medicaid patients increased. Therefore, legislation that increases healthcare access may increase the utilization of surgical care for diverticular disease. [ABSTRACT FROM AUTHOR]

Patient: Female, 83-year-old Final Diagnosis: Eosinophilic gastroentritis * jejunal diverticulosis Symptoms: Abdominal pain * obstruction Medication: -- Clinical Procedure: -- Specialty: Surgery Objective: Rare coexistence of disease or pathology Background: Eosinophilic gastroenteritis is a broad classification of disease characterized by eosinophilic infiltration of the gastrointestinal tract in the absence of a stimulatory cause. Given the ability of eosinophilic gastroenteritis to affect the entire gastrointestinal tract, it can present in a variety of ways, from chronic intermittent pain to mechanical obstruction. We present a rare case in which eosinophilic gastroenteritis of the jejunum led to small bowel diverticulosis and volvulus, requiring surgery. Case Report: An 83-year-old woman with a history of chronic abdominal pain, nausea, and early satiety presented to our clinic after a thorough gastrointestinal workup and radiologic diagnosis of partial midgut volvulus. She underwent an exploratory laparotomy and was found to have normal rotational anatomy with prominent small bowel diverticulosis. A section of 70 cm of proximal jejunum was resected, encompassing all visible diverticula, and a primary anastomosis was performed. The patient recovered without complication. She was seen at follow-up with complete resolution of her presenting symptoms. Conclusions: We propose that this patient's pathology was caused by chronic intermittent obstructions related to eosinophilic gastroenteritis, leading to repeated periods of increased intraluminal pressure and severe small bowel diverticulosis. This case highlights the importance of maintaining an index of suspicion for small bowel diverticulosis in the setting of chronic eosinophilic gastroenteritis. [ABSTRACT FROM AUTHOR]

Introduction: While Asian populations develop colonic diverticular disease predominantly in the right colon, Western populations mainly present with left‐sided disease. The present study aimed to clarify the outcomes of surgical treatment for right‐sided colonic diverticular bleeding. Methods: Medical records of 43 patients who underwent surgery for right‐sided colonic diverticular bleeding between 2010 and 2019 were reviewed. Those whose general condition became unstable underwent open surgery at our institution. Patients were then divided into two groups, the open surgery group (n = 17) and laparoscopic surgery group (n = 26), after which operative outcomes between both groups were compared. Results: This study included 36 men and seven women with a median age of 76 (range: 37‐91) years. Laparoscopic surgery had a significantly longer operative time (183.5 minutes vs 110 minutes; P <.001) and significantly lower intraoperative blood transfusion rate (19.2% vs 82.4%; P <.001) than open surgery. The laparoscopic surgery group had earlier resumption of postoperative meals than open surgery group (postoperative day 3 vs postoperative day 4; P =.010). No significant difference in postoperative complications was observed between both groups. With regard to long‐term outcomes, none of the cases exhibited rebleeding from the right‐sided colon. Conclusion: The present study revealed that laparoscopic surgery promoted lower intraoperative blood transfusion rates and earlier resumption of postoperative meals compared to open surgery for right‐sided colonic diverticular bleeding. Hence, laparoscopic surgery can be feasible for right‐sided colonic diverticular bleeding provided that the patientʼs general condition is stable. [ABSTRACT FROM AUTHOR]

Background: Once considered to be a congenital condition, the epidemiology of right‐sided colonic diverticulosis (RCD) is evolving. Acute diverticulitis (AD) is a complication of RCD which is frequently misdiagnosed as appendicitis, resulting in unnecessary surgery, as there is strong evidence supporting medical management for right‐sided AD. In general, the incidence of AD correlates with the prevalence of RCD, which shows marked geographic variation. Few data reporting RCD prevalence come from Western countries, so the aim of this study is to define the prevalence of RCD in a New Zealand population. Methods: Independent review of the imaging from 1000 consecutive patients undergoing a computed tomography Kidney/Ureter/Bladder scan for suspected urolithiasis at Christchurch Hospital between January and November 2017 was undertaken, to determine the presence or absence, and distribution of colonic diverticulosis. Patients were excluded if they had a history of colonic resection, known IBD, or were less than 18‐years old. Results: Thirty‐one patients were excluded, leaving 969 eligible patients. Overall, 95 patients (9.8%) had RCD identified. The prevalence of RCD increased significantly with advancing age, being present in 2.3% of those aged 18–29, increasing to 20.3% in those greater than 70‐years old (p < 0.001). Conclusion: The prevalence of RCD in a New Zealand population is relatively high and increases significantly with age. This adds support to the role of cross‐sectional imaging in the evaluation of suspected appendicitis, to exclude right‐sided AD. The association with advancing age supports RCD being an acquired condition rather than a congenital condition as was previously thought. [ABSTRACT FROM AUTHOR]

Aim: Diverticular disease is widespread worldwide. Mainstay approach is non-operative treatment with bowel rest and broad-spectrum intravenous antibiotics. However, extra-colic abscess larger than 4 cm may require percutaneous trans-abdominal drainage. We report a single centre case series of patients underwent to trans-luminal endoscopic ultrasound (EUS)-guided drainage of pelvic abscess in diverticular disease with temporary placement of lumen apposing metal stent (LAMS). Methods: All patients referred to our tertiary centre from January 2019 to July 2020 were enrolled in a prospective data base that was retrospectively analysed. Procedural steps were as follows: pre-operative computed tomography scan, broad-spectrum antibiotic therapy, EUS-guided deployment of LAMS for 15 days, LAMS removal and deployment of pigtail stent in case of pseudo-cavity persistence. Results: Ten patients (6F) with an average of 59.6 years were enrolled with deployment of 10 LAMS. One patient was excluded after EUS evaluation and 1 patient had 2 LAMS for 2 separate abscesses. Technical and clinical success was achieved in 88.8% (8/9). Conclusions: Management of diverticulitis has shifted from primary surgical intervention towards a non-operative approach of bowel rest and broad-spectrum intravenous antibiotics in conjunction with interventional procedures to drain abscesses whenever necessary. EUS-guided drainage with LAMS for the management of diverticular abscesses seems an efficient treatment modality for encapsulated abscesses more than 4 cm in size and close to colonic wall. In expert centres, it may avoid radiologic intervention and/or surgery in a relevant percentage of cases. [ABSTRACT FROM AUTHOR]

Background: Hemorrhoids are swollen veins of the hemorrhoidal plexus that are normally present in the anal canal. Clinically detectable if the supporting connective tissue is compromised. In this study, we focused on the effectiveness and importance of colonoscopy for studying the prevalence of internal hemorrhoids. Objective: The study aimed to evaluate the prevalence of internal hemorrhoids in patients undergoing colonoscopy for different indications. Patients and Methods: This cross-sectional study was conducted in the Elective Gastrointestinal Endoscopy Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University. The study was conducted through the period from March 2021 to Augustus 2021, and including 300 consecutive Egyptian patients who underwent a flexible colonoscopy for different reasons. Results: In the present study, we revealed that hemorrhoids increasing with aging. The diagnostic results were internal hemorrhoids (38.3%), colonic ulcers (11%), inflammatory lesions (7.3%) and mass (7%), diverticular disease (6%), polyps (5.7%), and vascular malformations (1.3%). The complaints of the patients were lower GI bleeding (41.7%). Chronic diarrhea (17.7%), abdominal pain (14.7%), and chronic constipation (13.3%) in the subsequent levels. Also, chronic anemia (6.7%), follow-up colon polyp (5.3%), one patient had weight loss (0.3%) and one patient had anal pain (0.3%). Conclusions: We can conclude a wide prevalence of internal hemorrhoids in patients who underwent colonoscopy for various reasons. Besides, retroflexed colonoscopy can contribute to the study of the prevalence of internal hemorrhoids because it can diagnose even asymptomatic hemorrhoids. In addition, colonoscopy was found to be extremely safe and no complication was detected. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Hartmann procedure can be necessary for the treatment of rectal cancer and colonic perforation. The distal diverted intestinal tract is usually disregarded, while the proximal colon is diverted with a stoma. Most of the reported complications related to a diverted intestinal tract following Hartmann procedure include inflammation and intestinal tumors; however, there are only a few reports about postoperative anal complications. Herein, we report a rare case of anal atresia following Hartmann procedure. Anal atresia is generally considered as a congenital malformation; therefore, this was an extremely rare case, as there are no previous reports about anal atresia following Hartmann procedure. Case Report: An 84-year-old woman presented to our hospital with a persistent feeling of incomplete evacuation. She had undergone Hartmann procedure for diverticular disease of the sigmoid colon, with perforation, 5 years ago and had no major complications after the surgery. She had no history of anal disorders such as hemorrhoids or anal fissures. On examination, her anus was found to be closed by a thin skin, and computed tomography revealed stool retention in the diverted rectum. The anus was surgically opened to remove the stool, after which the feeling of incomplete evacuation resolved with no subsequent recurrence. Conclusions: This is the first report of anal atresia in a patient following Hartmann procedure. The surgical intervention was effective in resolving the blockage and relieving the patient's feeling of incomplete evacuation. [ABSTRACT FROM AUTHOR]

Introduction: The etiology of diverticulosis is still poorly understood. However, in patients with diverticulitis, markers of mucosal inflammation and microbiota alterations have been found. The aim of this study was to evaluate potential differences of the gut microbiota composition and mucosal immunity between patients with asymptomatic diverticulosis and controls. Methods: We performed a prospective study on patients who underwent routine colonoscopy for causes not related to diverticular disease or inflammatory bowel disease. Participants were grouped based on the presence or absence of diverticula. Mucosal biopsies were obtained from the sigmoid and transverse colon. Microbiota composition was analyzed with IS-pro, a 16S-23S based bacterial profiling technique. To predict if patients belonged to the asymptomatic diverticulosis or control group a partial least squares discriminant analysis (PLS-DA) regression model was used. Inflammation was assessed by neutrophil and lymphocyte counts within the taken biopsies. Results: Forty-three patients were enrolled. Intestinal microbiota profiles were highly similar within individuals for all phyla. Between individuals, microbiota profiles differed substantially but regardless of the presence (n = 19) of absence (n = 24) of diverticula. Microbiota diversity in both sigmoid and transverse colon was similar in all participants. We were not able to differentiate between diverticulosis patients and controls with a PLS-DA model. Mucosal lymphocyte counts were comparable among both groups; no neutrophils were detected in any of the studied biopsies. Conclusions: Microbiota composition and inflammatory markers were comparable among asymptomatic diverticulosis patients and controls. This suggests that the gut microbiota and mucosal inflammation do not play a major role in the pathogenesis of diverticula formation. [ABSTRACT FROM AUTHOR]

Aim: In patients with anorectal Crohn's disease, it remains uncertain whether a total proctocolectomy with end ileostomy or proctectomy with end colostomy should be recommended due to the unknown rate of disease recurrence in the remaining colon. Methods: A retrospective review of all patients with a known diagnosis of Crohn's disease who underwent a proctectomy with end colostomy for distal Crohn's disease between January 1, 2010 and January 1, 2019 at two IBD referral centres was conducted. Data collected included patient demographics, surgical variables at the time of proctectomy, and postoperative clinical, endoscopic and surgical recurrence rates. Results: A total of 63 patients were included; mean age was 47 years (SD 15 years) and 32 (50.8%) were female. The majority of patients underwent a proctectomy with end colostomy (n = 56; 88.9%) while the remaining seven patients (11.1%) underwent a proctectomy with end colostomy and concurrent ileocectomy. A total of 55 patients (87.3%) had proctitis, 51 (81%) had perianal fistulating disease, and 34 (54%) had anal canal stenosis or ulceration. Most patients had medically refractory disease (n = 54; 85.7%) versus neoplasia (n = 9; 14.3%). The median length of long‐term follow‐up was 17.7 months (IQR: 4.72, 38.7 months). During that time, 14 (22.2%) experienced clinical recurrence, 10 of 34 evaluated (29.4%) had endoscopic recurrence, and 3 (4.76%) required a completion total abdominal colectomy for recurrent medically refractory disease in the colon. Conclusion: Colonic recurrence remains low following proctectomy and descending colostomy suggesting this operative management strategy is reasonable in Crohn's patients with distal disease. [ABSTRACT FROM AUTHOR]

Dietary fiber intake helps to maintain gut homeostasis. Fiber deficiency causes commensals to utilize mucins as an energy source to destroy mucus layer, thus promoting susceptibility to inflammatory bowel disease. Here, we reported that oroxylin A, a natural flavonoid, ameliorated low-grade colonic inflammation caused by fiber deficiency, alleviated colitis, and further prevented colitis-associated colon cancer in mice. The anti-inflammatory effect of oroxylin A was due to its alteration of gut microbiota. We found that the levels of Eubacterium coprostanoligenes was significantly increased by oroxylin A and the colonized Eubacterium coprostanoligenes significantly protected against colitis and carcinogenesis in colon of mice. Together, our results in this study suggest that oroxylin A may reduce the susceptibility to intestinal diseases by increasing the level of Eubacterium coprostanoligenes which could provide a therapeutic alternation for the treatment of intestinal diseases. [ABSTRACT FROM AUTHOR]

The ability of the adult human brain to develop function following correction of congenital deafferentation is controversial. Specifically, cases of recovery from congenital visual deficits are rare. CNGA3-achromatopsia is a congenital hereditary disease caused by cone-photoreceptor dysfunction, leading to impaired acuity, photoaversion, and complete color blindness. Essentially, these patients have rod-driven vision only, seeing the world in blurry shades of gray. We use the uniqueness of this rare disease, in which the cone-photoreceptors and afferent fibers are preserved but do not function, as a model to study cortical visual plasticity. We had the opportunity to study two CNGA3-achromatopsia adults (one female) before and after ocular gene augmentation therapy. Alongside behavioral visual tests, we used novel fMRI-based measurements to assess participants' early visual population receptive-field sizes and color regions. Behaviorally, minor improvements were observed, including reduction in photoaversion, marginal improvement in acuity, and a new ability to detect red color. No improvement was observed in color arrangement tests. Cortically, pretreatment, patients' population-receptive field sizes of early visual areas were untypically large, but were decreased following treatment specifically in the treated eye. We suggest that this demonstrates cortical ability to encode new input, even at adulthood. On the other hand, no activation of color-specific cortical regions was demonstrated in these patients either before or up to 1 year post-treatment. The source of this deficiency might be attributed either to insufficient recovery of cone function at the retinal level or to challenges that the adult cortex faces when computing new cone-derived input to achieve color perception. [ABSTRACT FROM AUTHOR]

Diverticular disease is one of the most common causes of outpatient visits and hospitalisations across Australia, North America and Europe. According to the Gastroenterological Society of Australia (GESA, 2010), approximately 33% of Australians over 45 years of age and 66% over 85 years of age have some form of colonic diverticulosis. Patients with colonic diverticulosis are known to develop subsequent complications such as acute colonic diverticulitis (ACD), and when more than one attack of diverticulitis occurs, there is a 70‐90% chance that the individual will experience ongoing problems and recurring infections throughout their lifetime. Medical imaging is fundamental in the diagnosis, treatment and ongoing management of ACD and its complications, with Computed Tomography (CT) identified as the prevailing gold standard in the last few decades. Cross‐database searching highlighted a large gap in the literature regarding the effectiveness of Magnetic Resonance Imaging (MRI) as a non‐ionising radiation alternative imaging tool for ACD imaging after the mid‐2000s, despite ongoing technological advancements in this modality. This narrative review identified 13 key publications (11 primary prospective cohort studies, 1 systematic review and 1 meta‐analysis) that evaluate MRI for ACD imaging, of which five were published within the last decade. Several existing MRI protocols are deemed suitable for ACD imaging, and it is recommended they be re‐evaluated in larger cohorts. Future studies should consider the rapidly growing technological improvements of MRI, its cost efficiency and its applicability in modern day healthcare settings when addressing ACD management. This is especially important considering the gradual rise in radiation dose among the Australian population attributable to increased CT referrals, alongside increased reporting of ACD cases in younger individuals. [ABSTRACT FROM AUTHOR]

- Diverticulosis of the appendix, as a rare and incident disorder, mimics acute or chronic appendicitis and is characterized by herniation of the appendiceal mucosa through the muscular wall. Symptom and laboratory data of diverticular disease usually represent chronic inflammation. In this study, a 43-year-old female with a history of right lower quadrant pain and anorexia represented abdominal tenderness and rebound tenderness in the physical examination and normal laboratory tests. Abdominal sonography did not show any evidence of acute appendicitis. The removed appendix was 12 cm in length and had multiple diverticular protrusions along with it. The histologic examination showed diverticulosis without evidence of inflammation. The patient was discharged two days later in optimal clinical condition. Diverticulosis of the appendix often is confused with acute or chronic appendicitis based on similar presenting symptoms and imaging studies. Although surgery is the definitive treatment of both conditions, an appropriate diagnosis of diverticular disease before surgery is very important because of the association of appendiceal diverticular disease with neoplasm and other complications.

Abstract Duodenal diverticulosis can be a difficult CT diagnosis and should be considered in the differential diagnosis when a periduodenal mass‐like structure that may contain air, air‐fluid level, or oral contrast material is depicted.

Gut microbiota (GM) composition and its imbalance are crucial in the pathogenesis of several diseases, mainly those affecting the gastrointestinal tract. Colon diverticulosis and its clinical manifestations (diverticular disease, DD) are among the most common digestive disorders in developed countries. In recent literature, the role of GM imbalance in the onset of the different manifestations within the clinical spectrum of DD has been highlighted. This narrative review aims to summarize and critically analyze the current knowledge on GM dysbiosis in diverticulosis and DD by comparing the available data with those found in inflammatory bowel disease (IBD). The rationale for using probiotics to rebalance dysbiosis in DD is also discussed.

Aim: Diverticular disease is an increasingly common problem in Western society with a variety of treatment options for those presenting with acute diverticulitis, dependent on clinical presentation. Additionally, there is significant international variability in the index management, and few published data on real‐world clinical practice. The aim of DAMASCUS is to identify areas of practice variability and their potential association with differences in short‐ and medium‐term clinical outcomes. Methods and analysis: DAMASCUS is an international, collaborative, prospective observational study, recruiting patients from over 200 sites across six continents. The study opened in October 2020, with a rolling start. Identification of new sites ceased in February 2021 and data collection will cease in August 2021. All adult patients diagnosed with acute diverticulitis (radiologically or intra‐operatively) at each participating centre will be included. The primary objective of DAMASCUS is to assess for national and international variability in the presentation and index management of acute diverticulitis (medical, interventional radiology and surgical). Secondary objectives include assessing 30‐day and 6‐month clinical outcome data (readmission, re‐intervention, morbidity and mortality) and variations in surgical procedures for those undergoing surgery. All data will be recorded and managed using a secure REDCap electronic data capture tool and analysed using Stata (SE) version 16.1. The results will be reported in accordance with the STROBE statement. Conclusion: By analysing variations in the management of acute diverticulitis and the subsequent outcomes, DAMASCUS will be an important step towards identifying optimal care for patients with diverticulitis. [ABSTRACT FROM AUTHOR]

Background: Internal hernia (IH) is an infrequent complication following colorectal resection with minimally invasive technique. The real prevalence is difficult to define and there are only few large series reporting data on this complication, often focusing only on left-sided resections. Aim of the study was to evaluate the occurrence of IH following laparoscopic colorectal resection (LCR), reporting clinical presentation and treatment. Methods: Data from 1297 patients undergoing elective LCR for cancer or benign disease in a 15-year period (June 2005–March 2020) were prospectively collected. A database query was performed to search for small bowel obstructions requiring reintervention. Results: Five patients presented symptomatic IH (prevalence = 0.38%) and required reintervention. The preceding surgical procedure was left hemicolectomy for diverticular disease in all patients. The mesenteric defect had been originally closed in 4/5 patients. The median time interval between initial surgery and the occurrence of IH was 1 (range: 0.3–10) month. In all cases a small bowel loop was found herniating through the mesocolic defect. Small bowel resection was required in one patient only. The median hospital stay following reintervention was 7 (range: 4–17) days. Conclusions: IH following LCR is a rare but severe complication, potentially leading to death, if not promptly diagnosed and treated. Awareness of this complication, early recognition, and proper diagnostic and therapeutic management is mandatory allowing laparoscopic approach and often avoiding small bowel resection. [ABSTRACT FROM AUTHOR]

Diverticular disease can undermine health-related quality of life. The diverticulitis quality of life (DV-QOL) instrument was designed and validated to measure patient-reported burden of diverticular disease. However, values reflecting meaningful improvement (i.e., minimal clinically important difference [MCID]) and the patient acceptable symptom state (PASS) have yet to be established. We sought to establish the MCID and PASS of the DV-QOL and describe the characteristics of those with DV-QOL above the PASS threshold. We performed a prospective cohort study of adults with diverticular disease from seven centers in Washington and California (2016-2018). Patients were surveyed at baseline, then quarterly up to 30 mo. To determine the MCID and PASS for DV-QOL, we applied various previously established distribution- and anchor-based approaches and compared the resulting values. The study included 177 patients (mean age 57 y, 43% women). A PASS threshold of 3.2/10 distinguished between those with and without health-related quality of life–impacting diverticulitis with acceptable accuracy (area under the curve 0.76). A change of 2.2 points in the DV-QOL was the most appropriate MCID: above the distribution-based MCIDs and corresponding to patient perception of importance of change (AUC 0.70). Patients with DV-QOL ≥ PASS were more often men, younger, had Medicaid, had more serious episodes of diverticulitis, and had an occupational degree or high-school education or less. Our study is the first to define MCID and PASS for DV-QOL. These thresholds are critical for measuring the impact of diverticular disease and the evaluation of treatment effectiveness. [ABSTRACT FROM AUTHOR]

Purpose: There is an ongoing debate on whether or not to use oral antibiotic bowel decontamination in colorectal surgery, despite the numerous different regimens in terms of antibiotic substances and duration of application. As we routinely use oral antibiotic bowel decontamination (selective decontamination of the digestive tract (SDD) regimen and SDD regimen plus vancomycin since 2016) in surgery for diverticular disease, our aim was to retrospectively analyze the perioperative outcome in two independent centers. Methods: Data from two centers with a routine use of oral antibiotic bowel decontamination for up to 20 years of experience were analyzed for the perioperative outcome of 384 patients undergoing surgery for diverticular disease. Results: Overall morbidity was 12.8%, overall mortality was 0.3%, the overall rate of anastomotic leakage (AL) was 1.0%, and surgical site infections (SSIs) were 5.5% and 7.8% of all infectious complications including urinary tract infections and pneumonia. No serious adverse events were related to use of oral antibiotic bowel decontamination. Most of the patients (93.8%) completed the perioperative regimen. Additional use of vancomycin to the SDD regimen did not show a further reduction of infectious complications, including SSI and AL. Conclusion: Oral antibiotic decontamination appears to be safe and effective with low rates of AL and infectious complications in surgery for diverticular disease. [ABSTRACT FROM AUTHOR]

Background: Growing consideration in quality of life (QoL) has changed the therapeutic strategy in patients suffering from diverticular disease. Patients' well-being plays a crucial role in the decision-making process. However, there is a paucity of studies investigating patients' or surgery-related factors influencing the postoperative gastrointestinal function. The aim of this study was to investigate in a predictive model patients or surgical variables that allow better estimation of the postoperative gastrointestinal QoL. Methods: This observational study retrospectively analyzed patients undergoing elective laparoscopic sigmoidectomy for diverticulitis between 2004 and 2017. The one-time postoperative QoL was assessed with the gastrointestinal quality of life index (GIQLI) in 2019. A linear regression model with stepwise selection has been applied to all patients and surgery-related variables. Results: Two hundred seventy-two patients with a mean age of 62.30 ± 9.74 years showed a mean GIQLI of 116.39±18.25 at a mean follow-up time of 90.4±33.65 months. Women (n=168) reported a lower GIQLI compared to male (n=104; 112.85±18.79 vs 122.11±15.81, p<0.001). Patients with pre-operative cardiovascular disease (n=17) had a worse GIQLI (106.65 ±22.58 vs 117.08±17.66, p=0.010). Finally, patients operated less than 5 years ago (n=63) showed a worse GIQLI compared to patients operated more than 5 years ago (n=209; 111.98±19.65 vs 117.71±17.63, p=0.014). Conclusions: Female gender and the presence of pre-operative cardiovascular disease are predictive for a decreased postoperative gastrointestinal QoL. Furthermore, patients' estimation of gastrointestinal functioning seems to improve up to 5 years after surgery. [ABSTRACT FROM AUTHOR]

Laparoscopic adjustable gastric banding (LAGB) remains a popular procedure in the management of obesity worldwide. Associated complications include band slippage, port site infections and more rarely, band erosion. Though less common, band erosion is a serious complication that needs to be recognised promptly and managed accordingly. Presentation is often vague, ranging from mild pain and reflux to weight regain. The majority of band erosions occur and present within the first 2 years post‐operatively. However, as this case report demonstrates, clinicians should have a high index of suspicion for LAGB complications regardless of post‐operative duration. We present a rare case of very late complete band erosion in a 55 year old patient with known diverticular disease, presenting 10 years post‐operatively with sepsis and left iliac fossa peritonitis, mimicking severe diverticulitis. [ABSTRACT FROM AUTHOR]