Presentation
Lower abdominal pain and fever.
Patient Data
Two discrete rim enhancing pericolonic collections are seen at the rectosigmoid junction, measuring 5 x 4 and 3 x 2 cm, both containing locules of gas. There is associated pericolonic fat stranding. Furthermore extensive diverticulosis is noted in the descending and sigmoid colon. Fat stranding extends to the sigmoid mesocolon. No peritoneal free fluid or free gas.
Right inguinal hernia noted containing bladder diverticulum. Wedge-shaped hypodensity in segment IVb of the liver adjacent the falciform ligament is likely focal fatty infiltration. Liver is otherwise unremarkable. The spleen, pancreas, adrenals, stomach and bowel are unremarkable. Subcentimeter simple cyst in the upper pole of the left kidney. The kidneys are otherwise unremarkable. Minor dependent changes at the lung base. Linear atelectasis in the lingula. No suspicious osseous lesions.
Conclusion:
Findings are compatible with diverticulitis complicated by abscess formation. Incidental right inguinal hernia containing bladder.
Case Discussion
Diverticulitis is a common cause of abdominal pain. It is important to carefully review for complications (such as abscess or perforation) when the diagnosis of diverticulitis is made as these will typically alter the surgeon's management.