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"titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Divertículo colónico invertido – un diagnóstico cauteloso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 65427 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Inverted diverticulum in Narrow Band Imaging.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 65-year-old male with no past clinical history, undertakes a colonoscopy due to episodic pain in lower left quadrant and constipation.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In the sigmoid colon, we identified an elevated sessile lesion, covered by normal mucosa in white light (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and narrow-band imaging (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), with fine concentric folds surrounding it. It's characteristics did not change with water instillation.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">This endoscopic appearance is typical of inverted colonic diverticulum.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Inverted diverticula are rare findings, reported in less that 0.7% of colonoscopies. It is important to make a correct diagnosis of these lesions, since their erroneous interpretation as sessile polyps, with subsequent biopsy or polypectomy, can lead to colonic perforation.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The following endoscopic characteristics should be sought while diagnosing inverted colonic diverticulum:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0035" class="elsevierStylePara elsevierViewall">elevated sessile appearance with fine concentric pale rings surrounding the lesion, also called Aurora rings;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0040" class="elsevierStylePara elsevierViewall">mucosal pattern on lesion similar to surrounding mucosa;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0045" class="elsevierStylePara elsevierViewall">localization in area of diverticula;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0050" class="elsevierStylePara elsevierViewall">lesion reverts to typical diverticular appearance with direct water infusion, air insufflation, or gentle pressure with biopsy forceps.</p></li></ul></p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare having no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 61363 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Inverted diverticulum in white light.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 65427 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Inverted diverticulum in Narrow Band Imaging.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/24443824/0000004100000007/v2_201810040621/S2444382418301251/v2_201810040621/en/main.assets" "Apartado" => array:4 [ "identificador" => "75461" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24443824/0000004100000007/v2_201810040621/S2444382418301251/v2_201810040621/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382418301251?idApp=UINPBA00004N" ]
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