Perforated diverticulitis

Case contributed by Krishna Doshi
Diagnosis almost certain

Presentation

Abdominal pain and hypoxia.

Patient Data

Age: 80 years
Gender: Female
x-ray
ct

CT abdomen pelvis demonstrates a large pneumoperitoneum with transverse colon perforation, fluid surrounding the liver and spleen, and the presence of diverticular disease.

Case Discussion

An 80 year old patient presented with epigastric pain and dyspnea. CXR showed pneumoperitoneum. CT-AP demonstrated anterior inferior transverse colon perforation and diverticulitis. She had feculent peritonitis intraoperatively.

Acute diverticulitis is inflammation and micro-perforation of a diverticulum (sac-like outpouching of colonic mucosa) 1. Perforation occurs in 10-25% of patients and may require surgical management2.

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