Weber SA, Weber ÁP, Garteiz MD, Mitrani BC

Language: Spanish
References: 5
Page: 94-97
PDF size: 211.45 Kb.

ABSTRACT

Introduction: The giant colonic diverticulum is a rare complication of the diverticular disease and it is defined as that diverticulum 4 cm or larger in diameter. It is found most frequent in the sixth decade of life with no difference in sex distribution. The sigmoid portion is the most frequently affected. Its clinical presentation is variable with pain as the most common complaint, a mass is only reported in large diverticulum in 17% of the cases. Complications are common and perforation is the most severe and frequent. The best treatment is the surgical approach, it has been reported diverticular resection with or without colectomy in associated diverticular disease. There is only one report published by Pejvak and cols. that tried to remove this pathology laparoscopically, not being able to continue and then converting to an open conventional procedure. Case report: 56-year-male that started three years prior, with an acute colonic diverticular disease and two other acute events afterward, all of them treated within the hospital conservatively. In the last one an increase of volume in the lower abdomen was noticed. He then came to our facilities without an acute stage and normal vital signs. A fixed palpable mass was present in this abdominal region. CT showed diverticular disease with a giant, 15 cm sigmoid distended diverticulum, displacing the colon and ileal loops. It was approached laparoscopically performing a colonic resection including the diverticular disease and the diverticulum with intracorporeal anastomosis of a healthy colon. The follow-up was without complications with a hospital stay of four days post-op. Conclusions: The giant colonic diverticulum is a rare complication of the diverticular disease. Laparoscopic surgery could be a feasible alternative for this problem with the advantages of minimally invasive surgery.

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