Snapshot quiz 19/3

Published: 02/06/2019

Authors: Clements JM, McCanny A and Campbell W

A 76-year-old man presented with a 4-day history of vomiting, increasing abdominal pain and distension. CT demonstrated a giant colonic diverticulum in free communication with the sigmoid apex with impending perforation (a). The man proceeded to laparotomy where a sigmoid colectomy was performed (b). Giant colonic diverticulum is a rare entity arising as a consequence of diverticular disease. Potential complications include acute perforation, colonic obstruction, volvulus and infarction. Operative strategies include open/laparoscopic segmental resection and primary anastomosis in uncomplicated cases, or Hartmann’s procedure in complicated cases. Endoscopic investigation is not recommended.