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Obstructive colonic diverticular stricture

Case contributed by Dr Michael P Hartung

Presentation

Abdominal pain, nausea, and vomiting

Patient Data

Gender: Male

Diffuse dilation of fluid-filled small and large bowel. Transition point in the distal descending/proximal sigmoid colon, with some minor wall thickening and irregularity. Few small sigmoid divertciula. 

Case Discussion

Small and large bowel obstruction due to a benign colonic diverticular stricture (confirmed by endoscopic biopsy and pathologic specimen). The appearance is actually most concerning for a malignant stricture, as on the coronal images there appears to be thickened enhancing soft tissue near the proximal transition point - specifically a scirrhous type of adenocarcinoma. The next appropriate step for this patient is to have a gastroenterology consultation, who can consider a diagnostic (biopsy) and therapeutic (stent) colonoscopy, which was done in this case confirming a benign diagnosis and placing a temporary stent to relieve the obstruction.  

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Case information

rID: 81085
Published: 2nd Sep 2020
Last edited: 3rd Sep 2020
Inclusion in quiz mode: Included

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