Sigmoid diverticular perforation

Case contributed by Dr Ian Bickle


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

Patient Data

Age: 70 years
Gender: Male



Thickened apex to the sigmoid loop just prior to the take-off of the descending colon, containing multiple diverticula. 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 are otherwise normal.


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 an inflamed colonic segment, sealed off localized perforation and larger perforation with or without a collection.

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