Presentation
Abdominal distension, abdominal pain and constipation for one week. Associated with low grade fever.
Patient Data
Air-filled large bowel loops which are slightly prominent, but within normal diameter.
No dilatation of small bowel loops.
No pneumoperitoneum.
A long segment of segmental large colonic wall thickening at the sigmoid colon with "water target appearance", measures approximately 20cm in length. It is associated with pericolic stranding and enhancement of the bowel wall.
No pneumoperitoneum.
Case Discussion
It is in keeping with acute sigmoid diverticulitis (Hinchey classification stage Ia).
No CT evidence of perforation or abscess formation. The two ill-defined with slightly higher attenuating liver lesions may represent liver abscesses.
The patient was treated with antibiotics and recovered uneventfully. He was scheduled for an elective colonoscopy as an outpatient.