Sigmoid diverticular perforation

Case contributed by Dr Ian Bickle

Presentation

Retired gentleman with short history of fever and abdominal discomfort. Hypotensive. LIF mass palpable.

Patient Data

Age: 71
Gender: Male
Modality: CT

CT abdomen

Thickened apex to the sigmoid loop just prior to the take-off of the descending colon, containing multiple diverticulae. Adjacent to this is a 10 cm fluid-gas containing collection with surrounding inflammatory change.

No free gas in the upper abdomen.

Tiny simple cyst in the liver. Solid organs otherwise normal.
 

Modality: Photo

The surgical notes from the laparotomy concur with the CT findings.

Case Discussion

The typical appearances of a colonic diverticular perforation with a large resultant abscess/inflammatory mass.

The spectrum of acute diverticular disease can range from a single inflamed diverticulum, through to a inflamed colonic segment, sealed off localized perforation and larger perforation with or without a collection.

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Case Information

rID: 48496
Case created: 10th Oct 2016
Last edited: 12th Oct 2016
Inclusion in quiz mode: Included

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