Giant Sigmoid Diverticulum: A Rare Presentation of a Common Pathology

Abstract

Although colonic diverticulum is a common disease, affecting about 35% of patients above the age of 60, giant sigmoid diverticulum is an uncommon variant of which only relatively few cases have been described in the literature. We report on our experience with a patient affected by giant sigmoid diverticulum who was treated with diverticulectomy. Resection of the diverticulum is a safe surgical procedure, provided that the colon section close to the lesion presents no sign of flogosis or diverticula; in addition, recurrences are not reported after 6-year follow-up.

A Rare Case Presentation of a Perforated Giant Sigmoid Diverticulum

“…In rare cases, the wall may contain other substances or disease, including amyloid [17], lymphoma of mucosa-associated lymphoid tissue (MALT) [8], and urothelium [4, 15]. …”

“…First, the neck or stalk of the diverticulum becomes obliterated by chronic inflammation, and then gas is produced from the organisms located within the cyst, which progressively distends and enlarges the diverticulum [8, 9, 17]. The more accepted theory has been the “ball-valve theory” for several reasons.…”

“…The few reported cases of a true colonic diverticulum occurred at a slightly younger age suggesting a possible congenital component [ 5 , 12 ]. Sex distribution is equal [ 1 , 2 , 7 , 8 , 10 , 12 – 15 ]. Ninety-five percent of giant colonic diverticula are found on the antimesenteric side of the sigmoid colon [ 16 ], and in only a few cases of a true giant diverticulum was the diverticulum found on the mesenteric side of the bowel wall [ 5 , 16 ].…”

“…The size of a giant diverticulum waxes and wanes increases by straining of stools and gradually increases over years [ 1 ]. The adjacent colon is often irritable and edematous and may be compressed by the GCD [ 8 ]. The segment of colon from which the giant air cyst arises is always deformed by diverticular disease and may be simultaneously compressed by the cyst [ 16 ].…”

Measuring the space between vagina and rectum as it relates to rectocele

“…Most surgeons advocated operative repair if the quality of life of the patient was affected, for instance they had a large symptomatic rectocele and failed to empty sufficiently. Surgery for rectocele repair included several different techniques using different approaches, ranging from the endorectal to the perineal or vaginal route [15,16] . Endorectal rectocele repair was developed by Sullivan [17] ; it's advantages included an ability to deal with coincident anorectal pathology (in particular hemorrhoids and anterior mucosal rectal prolapse), with a definitive defect-specific septal repair and excision of the redundant rectal mucosa.…”