Giant congenital diverticulum of the sigmoid colon

Abstract

Congenital, or true, diverticulum of the colon containing all layers of the bowel *all is uncommon but is known to occur infrequently in the cecum and ascending colon where it may produce symptoms of acute diverticulitis.‘W4 An 8-yr-old boy was recently admitted for excision of a large diverticulum of the sigmoid colon associated with chronic constipation, recurrent fecal impaction, and enuresis. At I day ot age he had undergone repair of a right diaphragmatic hernia and had done well until 4 yr later when he presented with chronic constipation. a firm suprapubic mass. and a left inguinal hernia. After disimpaction, a barium enema demonstrated a pouch-like dilatation of the anterior border of the lower sigmoid colon (Fig. I). Proctoscopy to I5 cm revealed normal mucosa. and biopsy showed normal ganglion cells. The inguinal hernia was repaired, and although it was felt that excision of the diverticulum was advisable, it was not until the child was 8 yr old that the parents agreed to operation. During the interim 4-yr period the patient required daily mlneral oil and cathartics to avoid recurrent fecal impactions. At laparotomy a 6.5 x 3.5-cm pale, thick-wailed diverticulum was found projecting from the