Patients often present with the classic triad of left lower quadrant pain, fever, and leukocytosis (an elevation of the white cell count in blood tests). Patients may also complain of nausea or diarrhea; others may be constipated.

Less commonly, an individual with diverticulitis may present with right-sided abdominal pain. This may be due to the less prevalent right-sided diverticula or a very redundant sigmoid colon. Some patients report bleeding from the rectum.
Diverticulitis

The most common symptom of diverticulitis is abdominal pain. The most common sign is tenderness around the left side of the lower abdomen. If infection is the cause, then nausea, vomiting, fever, cramping, and constipation may occur as well. The severity of symptoms depends on the extent of the infection and complications. Diverticulitis may worsen throughout the first day, as it starts as small pains and/or diarrhea, and may slowly turn into vomiting and sharp pains.

Foods such as seeds, nuts, and corn were, in the past, thought by many health care professionals to possibly aggravate diverticulitis. However, recent studies have found no evidence that suggests the avoidance of nuts and seeds prevents the progression of diverticulosis to an acute case of diverticulitis. Not only has this research shown that they do not appear to be aggravating the diverticulitis, but it appears that a higher intake of nuts and corn could in fact help to avoid diverticulitis in male adults. Most cases of simple, uncomplicated diverticulitis respond to conservative therapy with bowel rest and antibiotics. Despite being recommended by several guidelines, the use of antibiotics in mild cases of uncomplicated diverticulitis is supported with only “sparse and of low quality” evidence, with no evidence supporting their routine use. However, recurring acute attacks or complications, such as peritonitis, abscess, or fistula may require surgery, either immediately or on an elective basis.

People may be placed on a low residue diet. This low-fiber diet gives the colon adequate time to heal without needing to be overworked. Later, patients are placed on a high-fiber diet.

A simple technique is described that allows the orthopaedic surgeon to perform no-hands retraction during the lateral approach to the proximal femur during fixation of an intertrochanteric fracture with a sliding hip screw. All instruments remain sterile and within 6 inches of the surgical wound. Use of this technique is particularly useful in the event that a surgeon is operating with only one surgical assistant who may not be able to provide adequate assistance with retraction while concurrently preparing surgical instruments.

The Philadelphia chromosome is formed when a piece of chromosome 9 exchanges places with a piece of chromosome 22, resulting in a balanced translocation t(9;22)(q34;q11) and the formation of an abnormal fusion gene BCR-ABL1.

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm. The American Cancer Society estimated that in 2012, the number of newly diagnosed CML cases would be 5,430, with 610 deaths.1 The discovery of the tyrosine kinase inhibitor (TKI) imatinib has revolutionized the treatment and prognosis of CML, making imperative early recognition of CML. Timely diagnosis will ensure that patients receive early treatment, significantly improving their prognosis.

CML is caused by a cytogenetic abnormality that is thought to be acquired and involves a balanced translocation between chromosome 9 and chromosome 22. The BCR gene on chromosome 22 fuses with the ABL1 gene on chromosome 9, resulting in the abnormal fusion gene BCR-ABL1 located on chromosome 22 (Figure 1). The fusion gene produces a protein with tyrosine kinase activity that causes cells to proliferate. The resultant abnormal chromosome 22 [t(9;22)(q34;q11)] is also known as the Philadelphia (Ph) chromosome. It is identified in 95% of patients with CML and can be detected in all myeloid cells, including granulocytes, erythrocytes, monocytes, and B lymphocytes

A craniopharyngioma is a benign tumor that develops near the pituitary gland (a small endocrine gland at the base of the brain). This tumor most commonly affects children 5 – 10 years of age. Adults can sometimes be affected. Boys and girls are equally likely to develop this condition.
Craniopharyngioma causes symptoms in the following ways:

1. Increasing the pressure on the brain (intracranial pressure)
2. Disrupting the function of the pituitary gland
3. Damaging the optic nerve

Increased pressure on the brain causes headache, nausea, vomiting (especially in the morning), and difficulty with balance. Damage to the pituitary gland causes hormone imbalances that can lead to excessive thirst, excessive urination, and stunted growth. When the optic nerve is damaged by the tumor, vision problems develop. These defects are often permanent, and may get worse after surgery to remove the tumor.

Behaviorial and learning problems may be present. Most patients have at least some vision problems and evidence of decreased hormone production at the time of diagnosis.

Traditionally, surgery has been the main treatment for craniopharyngioma. However, radiation treatment instead of surgery or along with a smaller surgery may be the best choice for some patients. In tumors that cannot be removed completely with surgery alone, radiation therapy is usually necessary. If the tumor has a classic appearance on CT scan, a biopsy may not be necessary if treatment with radiation alone is planned. Stereotactic radiosurgery is performed at some medical centers. This tumor is best treated at a center with experience in treating patients with craniopharyngiomas. [Source: A.D.A.M. Medical Encyclopedia.]

Depicted are a montage of images illustrating common symptoms and treatment for IBD including stomach cramping, abdominal discomfort, the urge to use the bathroom, colon spasms and the use of antispasmodics such as hyoscyamine sulfate.

According to the featured article, “Irritable bowel syndrome (IBS) is defined as abdominal discomfort or pain associated with altered bowel habits for at least 3 days per month in the last 3 months in the absence of organic disease.  In the U.S., the prevalence of IBS is 5-10% with peak prevalence in the third and fourth decades.  Abdominal pain is the most common symptom and is often described as a cramping sensation.  The absence of abdominal pain essentially excludes IBS. Other common symptoms include diarrhea, constipation, or alternating diarrhea and constipation.  The goals of treatment are alleviation of symptoms and improvement in quality of life.  Exercise, psyllium fiber, antibiotics, antispasmodics, peppermint oil and probiotics appear to improve symptoms of IBS.  Over-the-counter laxatives and antidiarrheals may improve stool frequency but not pain.  There is conflicting evidence to support the use of antidepressants; however, psychological therapies are effective compared to usual care treatments for improvement in IBS symptoms. Lubiprostone (Amitiza™) is effective for the treatment of constipation-predominant IBS.  Alosetron (Lotronex™) and Tegaserod (Zelnorm™) are FDA-approved for patients with severe IBS symptoms who have failed conventional therapy.”