Acute diverticulitis

Case contributed by Dr Sami Elhinnawi

Presentation

Acute left iliac fossa pain, tenderness and fever.

Patient Data

Age: 40
Gender: Male
Ultrasound

Ultrasound images taken at the maximal point of tenderness guided by the patient revealed the following:

  • a segment of the descending colon (measuring about 7 cm in length) shows mural thickening with preserved gut signature and preserved stratification of the wall, the thickness is mostly perceived at the level of the submucosa (echogenic) with no evidence of wall destruction denoting an acute inflammatory process.
  • arising from the colonic wall is a blind pouch measuring about 1.5 x 2 cm (diverticulum), the pouch is surrounded by echogenic fat and streaks of fluid, inside the pouch is an echogenic structure casting deep shadowing mostly a fecolith impacted in the diverticulum.
  • picture of acute non-complicated diverticulitis.

Case Discussion

Ultrasound examination shows the typical findings of uncomplicated sigmoid colon acute diverticulitis.

Ultrasound is very useful in the diagnosis of diverticulitis guided by the patient's region of maximal tenderness.

The patient was treated with oral antibiotics and recovered completely.

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Case information

rID: 54926
Case created: 7th Aug 2017
Last edited: 12th Aug 2017
Inclusion in quiz mode: Excluded
Institution: Misr International Hospital

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