Giant Colonic Diverticulum a Rare Complication of a Common Disease

• Main Author: Marques,Isabel
• Publication Date: 2022
• Other Authors: Pereira,Ana, Ribas,Sónia, Reis,Mário
• Format: Report
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: http://scielo.pt/scielo.php?script=sci_arttext&pid=S2183-13512022000300027
• topic: Giant colonic diverticulum; Diverticular disease; Bowel obstruction; Computed tomography.

Abstract An 80-year-old patient presented to the emergency room with a bowel obstruction and a tender epigastric mass. An abdominal computed tomography (CT) described a closed loop small bowel obstruction. An exploratory laparotomy revealed a giant sigmoid diverticulum, of 11cm in diameter, which was resected. The specimen was a true McNutt's type III diverticulum. The patient was discharged after a normal postoperative period and did not suffer any recurrence during a follow-up of more than 6 months. This is a rare complication of a common disease with non-specific presentation and not always accurately described by CT scan. Apart from intestinal volvulus, differential diagnoses include duplication cyst, a giant Meckel’s or duodenal diverticulum, pancreatic pseudocyst and pneumatosis cystoides intestinalis. Surgical resection is the recommended treatment to avoid perforation and peritonitis. Diverticulectomy is a safe option for a patient with acute presentation in the emergency room.