Giant Colonic Diverticula

Abstract

Background: A rare complication of diverticulosis of the colon is giant colonic diverticula (GCD). The condition was first described in English literature in 1953 [1, 2]. Methods: A Medline search was undertaken for English, French and German language articles on ’giant colonic diverticula’. Results: A total of 135 patients were identified, presenting with a total of 155 GCD [1–98]. With a complication rate of 28% and an operative mortality of 5%, GCD seems to have a high clinical significance. Radiological examination of choice seems to be plain abdominal X-ray and CT examination, barium enema carries the risk of perforation of the diverticulum, and should not be performed. Conclusions: There are different therapeutic options, in our opinion diverticulectomy alone is not the treatment of choice. Because of the possibility of recurrence and oncological reasons, colectomy seems to be the best treatment. The creation of a protecting colostomy depends on other operative findings.

Giant sigmoid diverticulum with coexisting metastatic rectal carcinoma: a case report

“…It has been reported in different parts of the colon but in 81% of cases it occurred in the sigmoid colon and in nearly 90% of cases; there has been only one report of a single giant colonic diverticulum [2]. Most GDCs are diagnosed in elderly patients with mean age of presentation between 60 and 79 years.…”

“…Most GDCs are diagnosed in elderly patients with mean age of presentation between 60 and 79 years. Its size has been most frequently reported in the range of 4-9 cm and rarely above 25 cm [2]. …”

A giant sigmoid diverticulum presenting as an upper abdominal mass

“…Giant colonic diverticula are very rare with less than 140 cases reported in the literature [1]. The first case was reported in 1946 by Bonvin and Bonte [2] and Hughes and Green [3] described the first case in UK in 1953.…”

An 87-year-old man with a tympanic abdominal mass

“…2,3 In addition, giant diverticula carry a 2% risk of adenocarcinoma of the involved colon at the time of presentation. 3 The mechanism by which ordinary diverticula become giant diverticula is not fully understood.…”

“…2,3 In addition, giant diverticula carry a 2% risk of adenocarcinoma of the involved colon at the time of presentation. 3 The mechanism by which ordinary diverticula become giant diverticula is not fully understood. One theory is that colonic inflammation narrows the outlet and creates a "ball-valve" mechanism that allows air to enter but not escape the diverticulum, which results in its progressive dilatation.…”