Abstract
The aim of this article was to present our experience with CT-colonography evaluation of a case of giant colonic diverticulum. Despite the high prevalence of diverticular disease in the Western world, giant colonic diverticula are rare entities, with fewer than 200 cases reported in literature.
Highlights
INVESTIGATIONS Abdominal series consisting of posterioranterior upright view and supine lateral view radiographs of the abdomen showed a large well-defined oval air-filled formation in the lower abdominal cavity (Figure 1)
According to Italian guidelines for colorectal cancer screening, a CT colonography (CTC) (64-row CT scan; VCT, General Electric Healthcare, Waukesha, WI, USA) was performed: axial scans with sagittal and coronal reconstructed images showed a thickwalled, 7 cm cystic mass appeared to arise from the sigmoid colon (Figure 2)
Despite the high prevalence of diverticular desease in the Western world, giant colonic diverticula are rare entities, with fewer than 200 cases reported in literature
Summary
INVESTIGATIONS Abdominal series consisting of posterioranterior upright view and supine lateral view radiographs of the abdomen showed a large well-defined oval air-filled formation in the lower abdominal cavity (Figure 1). According to Italian guidelines for colorectal cancer screening (patients with positive faecal occult blood test after incomplete optical colonoscopy), a CT colonography (CTC) (64-row CT scan; VCT, General Electric Healthcare, Waukesha, WI, USA) was performed: axial scans with sagittal and coronal reconstructed images showed a thickwalled, 7 cm cystic mass appeared to arise from the sigmoid colon (Figure 2). Circumferential thickening of sigmoid colon walls was noted, consistent with inflammatory changes in severe diverticular desease. For the purpose of a complete preoperative study, a CT after intravenous injection of non-ionic iodinated contrast material (IomeronÒ 400, Bracco SpA, Milan, Italy) was performed; the wall of the formation showed a weak delayed enhancement. DIFFERENTIAL DIAGNOSIS The differential diagnosis includes sigmoid or cecal volvolus, pneumatosis cystoides intestinalis, intestinal duplication cyst, giant Meckel’s diverticulum and vesicoenteric fistula
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