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Acute uncomplicated sigmoid diverticulitis

Case contributed by Michael P Hartung
Diagnosis almost certain

Presentation

Left lower quadrant pain.

Patient Data

Gender: Male

Inflamed sigmoid diverticulum with surrounding stranding. Some reactive inflammation of the colon wall with submucosal edema. 

Hepatic steatosis. Nonobstructive left renal calyceal stone. Few borderline retroperitoneal and inguinal lymph nodes. 

Case Discussion

Typical case of acute uncomplicated diverticulitis. The "uncomplicated" part of the diagnosis refers to no abscess, fistula, perforation/free air, thrombophlebitis of the SMV/PV, or liver abscess. 

Few borderline enlarged lymph nodes could be a chronic, reactive finding or indicate lymphoproliferative disorder. It would be reasonable to biopsy the left inguinal lymph node under ultrasound if this patient does not have prior imaging to show these are stable. 

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