Giant colonic diverticulum: case report of a rare surgical condition

Introduction Giant colonic diverticulum (GCD) is rare phenomenon, with less than 200 cases described in the literature. One of the complications of GCD is diverticulitis. To date, there is paucity of data addressing the diagnosis and management of GCD complicated by acute diverticulitis. Objective To better understand the diagnostic tools, the initial management, and the long-term follow-up for this group of patients as well as to recommend a proper multidisciplinary approach to this infrequent disease. Method A systematic literature search was performed using the PubMed, Embase, and Cochrane databases to identify all the published studies on GCD complicated by diverticulitis. Two of the authors assessed the relevance of the included full-text papers. The articles were assessed independently. Results In total, 12 cases were identified. Our results show that 10/11 (91%) of the patients who had computed tomography (CT) scans during the initial evaluation had a correct diagnosis. There was no case of failure to non-operative approach (7/7). The patients who had an emergency operation were treated so due to diffuse peritonitis (two patients), acute hemorrhage arising from ulcers within the diverticula (one patient), and misdiagnosis (one patient). Conclusion Giant colonic diverticulitis is a very rare disease. Computed tomography scan is a valuable tool for the initial diagnosis as well as for treatment strategy planning. Non-operative management is a viable option for patients without diffuse peritonitis. Interval endoscopy is recommended if no contraindication exists.

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“…3 To date, fewer than 200 cases of GCD have been published. 4,5 Three types of GCD have been described [6][7][8][9] ;…”

Section: Introductionmentioning

confidence: 99%

Giant Colonic Diverticulitis, an Extremely Rare Presentation of a Rare Disease — Clinical Presentation and Literature Review

Bekhor

Orgad

Shmilovitch

et al. 2022

Journal of Coloproctology

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Totally laparoscopic management of a giant sigmoid colon diverticulum: Case report and review of literature

Taranto,

Sessa

et al. 2024

Il Giornale Di Chirurgia - Journal of the Italian Association of Hospital Surgeons

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The giant diverticulum of the sigmoid colon is a rare clinical condition characterized by a high risk of complications. Its etiology is multifactorial, with longstanding diverticular disease and motor dysfunction of the colon as risk factors. Even though its diagnosis could be challenging, clinicians can rely on barium enemas revealing the characteristic findings of a large, air-filled sac adjacent to the colon on a computed tomography scan and colonoscopy. The use of these tools aids in ruling out alternative diagnoses and confirming the presence of a diverticulum. Timely surgical management is essential, also in asymptomatic fit-for-surgery patients, to prevent potential complications.

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Giant colonic diverticulum: case report of a rare surgical condition

Cited by 2 publications

References 8 publications

Giant Colonic Diverticulitis, an Extremely Rare Presentation of a Rare Disease — Clinical Presentation and Literature Review

Giant Colonic Diverticulitis, an Extremely Rare Presentation of a Rare Disease — Clinical Presentation and Literature Review

Totally laparoscopic management of a giant sigmoid colon diverticulum: Case report and review of literature

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