Perforated diverticulitis

Case contributed by Dr Thuan Tzen, Koh

Presentation

Known sigmoid diverticulitis. Sudden increase in abdominal pain.

Patient Data

Age: 60
Gender: Female

CT Abdomen

Modality: CT

Circumferential wall thickening and luminal narrowing through a significant length of the sigmoid colon with extensive pericolonic fat stranding. Extra luminal collection containing fluid and gas measuring 21 x 25 mm is seen in the left iliac fossa inferior to the inflamed segment of sigmoid colon. There are additional scattered locules of free gas elsewhere in the abdomen, including under the left hemidiapragm. Appearances are in keeping with perforated sigmoid diverticulitis. 

Circumscribed 25 x 24 mm hypoattenuation focus with peripheral calcific foci in the right adnexae is compatible with a complex ovarian cyst and this needs to be further evaluated with a dedicated pelvic ultrasound. 

Case Discussion

Thickened, inflamed segment of sigmoid colon with small local collection containing fluid and gas, as well as trace to small volume pneumoperitoneum. Appearance is most consistent with sigmoid diverticulitis complicated by perforation. 

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Case Information

rID: 34858
Case created: 11th Mar 2015
Last edited: 4th Oct 2016
Tag: colon
Inclusion in quiz mode: Included

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