Sigmoid Diverticular Perforation in a 23-year-old patient: A Case Report

Document Type : Case Report

Authors

1 Department of General Surgery, Istanbul Sultanbeyli State Hospital, Istanbul, Turkey

2 Department of General Surgery, Pendik Medipol University Hospital, Istanbul, Turkey

10.30476/acrr.2023.98109.1169

Abstract

Introduction: Diverticulitis is inflammation of one or more adjacent diverticulums and the surrounding colon. Patients with diverticulitis typically present acute or subacute abdominal pain in the left lower quadrant. Most patients with diverticulitis are over 50; however, diverticulitis is increasingly common in the younger. Diverticulitis may present with acute abdomen by causing intra-abdominal perforation. Although it is infrequent, diverticulitis perforation should be considered in the differential diagnosis of young patients with acute abdomen.
Case Presentation: In this case, we present the acute abdomen secondary to diverticulitis perforation in a 23-year-old male patient. The patient's physical examination and computed tomography scan were interpreted as perforation. We performed explorative laparotomy. In the operation, the stomach and other lumen organs were intact. It was observed that there were diverticula in the sigmoid colon, intense inflammation in the colon serosa in the region of the diverticula, and a perforation area of 1 cm in diameter.
Conclusions: Diverticulitis usually presents with abdominal pain in the left lower quadrant of the elderly patient. However, it may present with acute abdomen by causing intra-abdominal perforation. Although it is infrequent, diverticulitis perforation should be kept in mind in the differential diagnosis of young patients presenting with acute abdomen.

Keywords

References

Figure 3: Colonoscopy view showing multiple diverticula in
the sigmoid colon (white arrows).
1. Laurell H, Hansson LE, Gunnarsson
U. Acute diverticulitis--clinical
presentation and differential
diagnostics. Colorectal disease : the
official journal of the Association of
Coloproctology of Great Britain and
Ireland. 2007;9(6):496-501; discussion
-2.
2. Wheat CL, Strate LL. Trends in
Hospitalization for Diverticulitis and
Diverticular Bleeding in the United
States From 2000 to 2010. Clinical
gastroenterology and hepatology :
the official clinical practice journal
of the American Gastroenterological
Association. 2016;14(1):96-103.e1.
3. Shahedi K, Fuller G, Bolus R, Cohen
E, Vu M, Shah R, et al. Long-term risk of acute diverticulitis among
patients with incidental diverticulosis
found during colonoscopy. Clinical
gastroenterology and hepatology:
the official clinical practice journal
of the American Gastroenterological
Association. 2013;11(12):1609-13.
4. Bharucha AE, Parthasarathy G,
Ditah I, Fletcher JG, Ewelukwa
O, Pendlimari R, et al. Temporal
Trends in the Incidence and
Natural History of Diverticulitis:
A Population-Based Study. The
American journal of gastroenterology.
2015;110(11):1589-96.
5. Mayumi T, Yoshida M, Tazuma S,
Furukawa A, Nishii O, Shigematsu
K, et al. The Practice Guidelines for
Primary Care of Acute Abdomen
2015. Japanese journal of radiology.
2016;34(1):80-115.
6. Muham mer Ergenç TKU.
Laparoscopic treatment of a rare cause
of acute abdomen; primary omental
torsion. Laparosc Endosc Surg Sci.
2021;28(2):125-7.
7. Ergenç M, Uprak TK. Appendiceal
Diverticulitis Presenting as Acute
Appendicitis and Diagnosed
After Appendectomy. Cureus.
2022;14(3):e23050.
8. Pautrat K, Bretagnol F, Huten N, de
Calan L. Acute diverticulitis in very
young patients: a frequent surgical
management. Diseases of the colon
and rectum. 2007;50(4):472-7.
9. Swanson SM, Strate LL. Acute Colonic
Diverticulitis. Annals of internal
medicine. 2018;168(9):Itc65-itc80.
10. Regenbogen SE, Hardiman KM,
Hendren S, Morris AM. Surgery for
diverticulitis in the 21st century: a
systematic review. JAMA surgery.
2014;149(3):292-303.
11. Faria GR, Almeida AB, Moreira H,
Pinto-de-Sousa J, Correia-da-Silva
P, Pimenta AP. Acute diverticulitis in
younger patients: any rationale for a
different approach? World journal of
gastroenterology. 2011;17(2):207-12.
12. Lahat A, Menachem Y, Avidan B,
Yanai H, Sakhnini E, Bardan E, et
al. Diverticulitis in the young patient-
-is it different ? World journal of
gastroenterology. 2006;12(18):2932-5.
13. Koo V, Strange J, Lam CY,
Epanomeritakis M. Young patients
with diverticular disease: a
preliminary quality of life study.
International journal of surgery
(London, England). 2007;5(4):244-9

Files

Share

How to cite

Statistics