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Perforated solitary mid-rectal diverticulum diagnosed with colonoscopy: a case report and literature review
(Oxford University Press (OUP), 2025-12-24)
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Avramoski, Vladimir
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Gjinoska, Klaudia
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Kostovska, Irena
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Stoicovski, Emil
Rectal diverticulum is an exceedingly rare clinical entity, typically occurring as a solitary lesion or, less frequently, as up to three diverticula. Its development is often associated with underlying conditions such as obstructive defecation syndrome, rectal malignancy, pelvic floor weakness, chronic rectal impaction, obesity, or infection-related muscular atrophy. Although uncommon, rectal diverticulitis represents a surgical emergency requiring timely recognition and management. In this case, a female patient presented with rectal bleeding and secondary anemia. During the clinical course, the patient developed pelvic sepsis secondary to rectal diverticulitis. Appropriate surgical intervention, combined with antimicrobial therapy and supportive management, led to a favorable outcome. Rectal diverticulitis is a rare but potentially life-threatening condition. Awareness of this entity and early diagnosis are essential to prevent severe complications such as perforation and pelvic sepsis. This case highlights the importance of considering rectal diverticulum in the differential diagnosis of lower gastrointestinal bleeding and pelvic infections.
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BLEEDING RECTAL VARICES IN A PATIENT WITH ETHYLIC LIVER CIRRHOSIS - A CASE REPORT
(SHMSHM - AAMD, 2022)
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Pislevski, Matej
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Avramoski, Vladimir
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We present a rare case of a 60-year-old patient with established ethylic liver cirrhosis and bleeding rectal varices, treated with endoscopic ligation by placing 3 rubber bands consequently. These porto-systemic shunts can cause life-threatening bleeding due to their larger diameter and circulation. Although so far no standardized protocols for their treatment have been adopted, the method used to treat our case, after one month of monitoring, has proven to be a less invasive effective solution for reducing the risk of bleeding. Our aim was to illustrate one of the possible therapeutic approaches and to point out the importance of taking this complication into account in differential thinking in patients presenting with hematochezia.
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Ceftriaxone associated urolithiasis in a child with hypercalciuria
(Hippokratio General Hospital of Thessalonki, 2011-04)
Lozanovski, Vladimir
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Avramoski, Vladimir
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We present a 5-year-old boy with pneumonia who complained of right lumbar pain on the 7(th) day of treatment with Ceftriaxone. Ultrasound examination revealed mild to moderate right hydronephrosis. Under spasmoanalgetic therapy and hydration there was spontaneous passage of three small calculi. Infrared spectroscopy showed that the calculi were composed of calcium-ceftriaxonate. Full metabolic investigation was performed and moderate hypercalciuria was detected, suggesting the role of hypercalciuria in ceftriaxone-associated nephrolithiasis.
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Thyrotoxicosis Associated with Cholestatic Jaundice Treated with Therapeutic Plasma Exchange–Case Report
(OMICS Publishing Group, 2017)
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Chalovska, Viktorija
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Avramoski, Vladimir

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