Perforated descending colonic diverticulitis into the anterior abdominal wall

Case contributed by Dr Chris O'Donnell

Presentation

Left iliac fossa pain for 10 days, but not unwell. Normal bowel motions. Patient was well and walked into private radiology clinic. Minor focal tenderness over a palpable mass in the left iliac fossa.

Patient Data

Age: 75 years
Gender: Female
CT

Oral contrast given but no IV contrast due to moderate renal dysfunction

Gas-filled fistula between the descending colon passing through the anterior abdominal wall to enter a large gas-filled cavity in the subcutaneous fat. Note reactive inflammatory change in surrounding fat.

Follow-up 1 month later (on oral antibiotics) showing closure of the fistula (arrow) but development of an abscess requiring surgical drainage

Case Discussion

Patient not unwell and treated with oral antibiotics only!
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Case information

rID: 16303
Published: 8th Jan 2012
Last edited: 16th Aug 2019
Tag: colon
Inclusion in quiz mode: Included

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