Sigmoid diverticular perforation

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Retired gentleman with short history of fever and abdominal discomfort. Hypotensive. LIF mass palpable.

Patient Data

Age: 70 years
Gender: Male

Abdomen

ct

Thickened apex to the sigmoid loop just prior to the take-off of the descending colon, containing multiple diverticula. Adjacent to this is a 10 cm fluid-gas containing collection with surrounding inflammatory change.

No free gas in the upper abdomen.

Tiny simple cyst in the liver. Solid organs are otherwise normal.

Photo

The surgical notes from the laparotomy concur with the CT findings.

Case Discussion

The typical appearances of a colonic diverticular perforation with a large resultant abscess/inflammatory mass.

The spectrum of acute diverticular disease can range from a single inflamed diverticulum, through to an inflamed colonic segment, sealed off localized perforation and larger perforation with or without a collection.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.