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

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.
 

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.

PlayAdd to Share

Case information

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

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.