Giant diverticulum of the sigmoid colon.
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The authors report a case of giant diverticulum of the sigmoid colon, a very rare complication of diverticulosis of the colon, since only 38 cases have been reported in the literature. The diverticulum was seen at barium enema in a 66-year-old man complaining of digestive symptoms consisting of lower abdominal pain, tenesmus, diarrhea and fever. Segmental resection of the sigmoid colon including the site of implantation of the diverticulum with end-to-end anastomosis at the same operative stage led to definitive cure. On the basis of a study of the literature, the authors define the clinical, diagnostic and pathogenic characteristics of the condition.
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Diverticulum of the cecum is a rare, benign, generally asymptomatic lesion that manifests itself only following inflammatory or hemorrhagic complications. A personal series of six cases discusses the difficulty of differential diagnosis at both the preoperative and intraoperative levels. The preferable treatment is simple resection.
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We report a case of a 32-year-old man admitted for massive rectal bleeding related to a solitary diverticulum of the right colon. A superior mesenteric angiogram performed in emergency indicated the site of bleeding, but the correct diagnosis was only established at the histologic examination of the right colon that was surgically resected.
An 80-year-old woman with sigmoïd diverticula was treated by corticosteroid for Horton disease. She presented abdominal pain, and abdominal mass in left iliac fossa. Radiological examinations revealed a colo-jejunal fistula. At laparotomy it was a giant diverticulum of colon sigmoid with fistula in the jejunum. The pathogeny of giant diverticulum and the role of corticosteroid are discussed.
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A case of acute perforation of a diverticulum of the ascending colon is presented. The ultrasound features that helped in making a pre-operative diagnosis are discussed. This rare surgical emergency and the similar clinical entities of perforated caecal or transverse colon diverticula are often clinically misdiagnosed as more common conditions such as acute appendicitis, acute cholecystitis or perforated ulcer. Awareness of this entity will help radiologists in making a correct pre-operative diagnosis.
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A complication of colonic diverticulosis, giant diverticula are seen above all in the sigmoid region. On the basis of a case involving the transverse colon, the authors stress the clinical and ultrasonographic pseudo-tumoural symptomatology as well as the degree of superinfection of the contents. Anatomical arguments would be in favour of pathogenesis by progressive increase in size of an ordinary diverticulum rather than by perforation with secondary encystment. Excision of the diverticulum required segmental colectomy.