Giant colonic diverticulum: atypical manifestation of diverticular disease

Authors

  • Oriana Nogueira Department of General Surgery, Coimbra University Hospital Center, Coimbra, Portugal
  • Mariana Lemos Department of General Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  • Mariana Duque Department of General Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  • Catarina Lopes Department of General Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  • Eva Santos Department of General Surgery, Coimbra University Hospital Center, Coimbra, Portugal; Department of General Surgery, Coimbra University Hospital Center, Coimbra, Portugal
  • Miguel Fernandes Department of General Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal

DOI:

https://doi.org/10.18203/2349-2902.isj20230982

Keywords:

Giant colonic diverticulum, Diverticular disease, Computed tomographic

Abstract

Giant Colonic Diverticulum (GCD) is a rare complication of a common disease, in which the symptomatology is nonspecific and whose diagnosis is essentially made by CT scan. A surgical ressection is the recommended treatment in order to avoid perforation or other complications. We present a case of a 74-year-old woman who went to the emergency department with complaints of intestinal obstruction and acute abdomen. An abdominal computed tomography (CT) revealed a mesenteric collection with 60 mm and air-fluid level compatible with an abscess, adjacent to a small bowel loop. An emergency laparotomy was performed, which revealed a cystic formation of 6 cm in the antimesentery border, dependant of the sigmoid colon, which was resected en bloc with the adjacent colon. The specimen classified it as type 2 diverticulum. The patient was discharged after a normal postoperative period.

References

Mahamid A, Ashkenazi I, Sakran N, Zeina A. Giant colon diverticulum: rare manifestation of a common disease. Isr Med Assoc J. 2012;14:331-2.

Zeina A, Nachtigal A, Matter I, Benjaminov O, Abu-Gazala M, Mahamid A, et al. Giant colon diverticulum: clinical and imaging findings in 17 patients with emphasis on CT criteria. Clin Imaging. 2013;37:704-10.

Carr, J. Case report of a giant colonic sigmoid diverticulum causing sigmoid volvulus. International Journal of Surgery Case Reports. 2017;31:197-9.

Nigri G, Petrucciani N, Giannini G, Aurello P, Magistri P, Gasparrini M, et al. Giant colonic diverticulum: Clinical presentation, diagnosis and treatment: Systematic review of 166 cases. World J Gastroenterol; 2015;21(1):369-8.

McNutt R, Schmitt D, Schulte W. Giant colonic diverticula – three distinct entities. Report of a case. Dis Colon Rectum. 1988;31:624-62.

Macht R, Sheldon H, Fisichella P. Giant colonic diverticulum: a rare diagnostic and therapeutic challenge of diverticular disease. J Gastrointest Surg. 2015;19:1559-60.

Praveen B, Suraparaju L, Jaunoo S, Tang T, Walsh S, Ogunbiyi O. Giant colonic diverticulum: an unusual abdominal lump. J Surg Educ. 2007;64:97-100.

Versaci A, Macrì A, Terranova M, Leonello, G, Caminiti R, Sfuncia G, et al. Volvulus due to giant sigmoid diverticulum: a rare cause of intestinal occlusion. Chir Ita. 2008;60:487-91.

Majeski J, Durst G. Obstructing giant colonic diverticulum. South Med J. 2000;93:797–9.

Thomas S, Peel R, Evans L, Haarer K. Best cases from the AFIP: Giant colonic diverticulum. Radiographics. 2006; 26(6):1869-72.

Beddy D, DeBlacam C, Mehigan B. An Unusual Cause of an Acute Abdomen. J Gastrointest Surg. 2010;14:216-7.

Downloads

Published

2023-03-31

Issue

Section

Case Reports