Acute diverticulitis

Case contributed by Dr Abraão Kupske

Presentation

Female patient, 45 yo, with pain in the left lower quadrant for 1 day, continuous, insidious, in "sting", moderate intensity, aggravated when walking. Relief with rest. Denies nausea / vomiting, fever, change in bowel habits. Has breast cancer history, currently receiving chemotherapy.

Patient Data

Age: 45 years
Gender: Female

Abdominal ultrasound (selected images)

Modality: Ultrasound

In the lower left quadrant of the abdomen, on the point of referred pain, there is a thick-walled colon, with absence of peristalsis and vascular flow slightly increased the Doppler study. There are some diverticula containing coprolites, the largest measuring 1.0 cm and associated with a significant increased echogenicity of adjacent fat. There are no adjacent collections.

CT Abdomen and pelvis

Modality: CT

There is in the left iliac fossa a segmental wall thickening of the descending colon, associated with thickening of the adjacent fat planes, with heterogeneous enhancement after contrast agent, suggesting edema. No evidence of mechanical obstruction, adjacent collections or other signs of complications.

Case Discussion

The patient was diagnosed as an uncomplicated acute diverticulitis case. As it was her first episode, she was discharged with antibiotic and symptomatic medications.

Acute diverticulitis results from inflammation of a colonic diverticulum. In some cases, acute diverticulitis may be caused by chemotherapy medication. Also, gastrointestinal metastases from breast carcinoma is another possible cause, although rare, and should also be considered. 

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Case Information

rID: 42245
Case created: 12th Jan 2016
Last edited: 25th Feb 2016
Inclusion in quiz mode: Included

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