title: Eversion and ligation of a diverticulum: report of an inspirational case and subsequent animal study.
abstract: Although most patients with colonic diverticula have no symptoms, perforation or bleeding can be troublesome. Recently, we treated an elderly patient with a diverticular perforation of the sigmoid colon who required a loop colostomy and later resection of the diseased colon. Between the operations, the colostomy resembled a sea slug with horns, which represented eversions of the diverticula. This interesting phenomenon suggests that diverticula may be everted as pseudopolyps and ligated endoscopically. Therefore, the procedure was tested on a Landrace pig, of which the large bowel wall was pulled with an endoscope at 9 different sites using forceps (n=6) or suction (n=3) and ligated. Four days later, reexamination revealed total necrosis at 8 sites and ulceration at 1. The animal was well. The bowel removed 2 weeks later showed mucosal fold convergences without perforations. Our procedure can be used for prophylactic or therapeutic treatment of patients with colonic diverticula.
authors.affiliation: Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, Sendagi, Bunkyo-ku, Tokyo, Japan. akimaru@nms.ac.jp
authors.forename: Koho
authors.initials: K
authors.lastname: Akimaru
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuruta
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Horikita
mesh_terms: D000369:Aged, 80 and over; D000818:Animals; D012809:Colon, Sigmoid / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods; D003125:Colostomy; D004241:Diverticulum, Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D008026:Ligation / Q000379:methods; D013552:Swine; D016896:Treatment Outcome