Perforated diverticulitis

Case contributed by Dr Thuan Tzen, Koh


Known sigmoid diverticulitis. Sudden increase in abdominal pain.

Patient Data

Age: 60
Gender: Female

CT Abdomen

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
Published: 26th Apr 2015
Last edited: 14th Aug 2019
Tag: colon
Inclusion in quiz mode: Included

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