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Journal of Radiological Review 2021 September;8(3):265-9

DOI: 10.23736/S2723-9284.21.00118-7


lingua: Inglese

Giant colonic diverticulum: a case report with review of the literature

Lorenzo VASSALLO 1 , Mirella FASCIANO 1, Federica GROPPO MARCHISIO 1, Roberto BORSA 2, Pietro COPPOLA 2, Marco BRUNETTI 3, Ginevra LAMANNA 3, Franco BERTOLINO 3

1 Unit of Radiology, S.S. Annunziata Hospital, ASLCN1, Savigliano, Cuneo, Italy; 2 Unit of Urology, S.S. Annunziata Hospital, ASLCN1, Savigliano, Cuneo, Italy; 3 Unit of General Surgery, S.S. Annunziata Hospital, ASLCN1, Savigliano, Cuneo, Italy

Giant colonic diverticulum (GCD), defined as a diverticulum larger than 4 cm, is a rare entity that generally represents a manifestation of diverticular disease. The etiology of GCD is not clearly understood and the clinical presentation varies considerably: ranging from an incidentally discovery in asymptomatic patients to acute presentation. Because of its rarity and variable, non-specific presentation, the diagnosis of GCD is generally radiological. Plain abdominal radiography remains a useful tool for first-line investigation due its simplicity and widespread availability, while CT provides definite diagnosis. In this paper we reported the case of an 83-year-old catheterized male presenting to our hospital with increasing abdominal pain, pneumaturia and fecaluria seven days after he underwent transurethral resection of the prostate (TURP). In the suspicion of colovesical fistula (CVF) patient underwent US which showed the presence of echogenic material in urinary bladder possibly representing fecal material. For further evaluation we performed a CT cystography that demonstrated one GCD associated with multiple sigmoid diverticula and a full-thickness defect of the posterior wall of the bladder with dislocation of the apex of catheter in the lumen of GCD. Subsequently patient underwent sigmoid colic resection and en-bloc diverticulum resection. After a few days he was discharged without perioperative or postoperative complications. Knowledge of the spectrum of radiographic and CT features of the GCD is important in making the correct diagnosis and potentially preventing complications.

KEY WORDS: Diverticulum; Colon; Diverticular diseases; Tomography; Intestinal fistula

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