Presentation
New onset of dull aching abdominal pain over the last week.
Patient Data
CT images show few scattered diverticular outpouchings of the colon. Mural thickening of the sigmoid colon with stranding of the surrounding fat planes denoting diverticulitis. There is mild amount of pelvic free fluid without abscess formation.
A small amount of pneumoperitoneum is also noted in keeping with perforation. No extraluminal contrast density could be seen suggesting the possibility of a sealed perforation.
The patient was managed conservatively but his abdomen became rigid and the inflammatory markers were increasing, for this, he was sent to the operative theater. A sigmoid perforation was confirmed (diverticulitis was confirmed histopathologically). He underwent sigmoid resection and primary repair.
Case Discussion
Sigmoid diverticulitis is the most common cause of left lower quadrant pain in adults. CT is considered the most appropriate diagnostic imaging tool to confirm suspected cases of diverticulitis and assess for associated complications.
In women of childbearing age, ultrasound is the initial preferred modality for unexplained left lower quadrant pain.
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