Presentation
Suspected complicated acute diverticulitis
Patient Data
CT shows sigmoid wall thickening with mucosa hyperemia and submucosal edema associated with pericolonic inflammatory changes. Diverticulae are presence at this level. In the cranial position and in close relation to previously described findings, an irregular collection of perceptible walls is present, with some bubbles of gas within, identifying a communicating fistula between the collection and an adjacent sigmoid loop. A second fistula that communicates the collection to an ileum segment is localized at the pelvic excavation. These findings were accompanied by moderate left hydroureteronephrosis, observing caliber change in the distal ureter, in relation to the previously described inflammatory changes.
Case Discussion
Findings consistent with complicated acute sigmoid diverticulitis with a pericolic abscess.
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