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At least 19 recordsLinked to original sources
PubMed1999

Amyloidosis presenting as a perforated giant colonic diverticulum.

Colonic amyloidosis is frequent, although rarely radiographically evident. The radiological findings are varied and unspecific. We report a case of perforated giant colonic diverticulum (GCD) diagnosed by helical CT in which amyloid deposition was pathologically demonstrated. The patient was a renal transplant recipient who previously had undergone hemodialysis for 10 years. A possible role of amyloidosis in the pathogenesis of this case is discussed. Giant colonic diverticulum must be included in the spectrum of gastrointestinal manifestations of amyloidosis.

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PubMed2005

Ruptured giant colonic diverticulum.

Giant colonic diverticulum (GCD) is a rare complication of diverticular disease with less than 150 cases reported in the English literature. The clinical presentation ranges from asymptomatic to that of an acute abdomen. In most cases, giant colonic diverticulum is found in the sigmoid colon. The ideal treatment is elective resection of the sigmoid colon with primary anastomosis. When the diverticulum presents with perforation or obstruction, however, the treatment is a sigmoid colectomy with diverting colostomy (Hartmann procedure).

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PubMed1984

Unusual manifestations of giant colonic diverticulum.

Giant colonic diverticulum is an uncommon complication of diverticulosis, with only 52 previously reported cases. Complications secondary to the giant air cysts occurred in only six instances, and all but one occurred in the sigmoid colon. Two additional cases are described, presenting atypical location, age, and complication by pneumoperitoneum.

Adult↗
PubMed2000

Uroepithelium in a colonic diverticulum.

Giant colonic diverticula are rare entities and often present in adulthood as acute diverticulitis. The authors present a case of giant colonic pseudodiverticulum lined with uroepithelium causing bowel obstruction in a neonate. The presence of uroepithelium in a colonic pseudodiverticuium remains unexplained and to the authors' knowledge unreported. This heterotopic tissue may be a result of an embryonic rest or could be urachal in origin adhering initially to the colon and eventually detaching from the umbilicus. These lesions should be resected because of the risk of infection, perforation, or obstruction.

Adult↗
PubMedDate not supplied

Giant colonic diverticulum.

BACKGROUND: Over 100 giant colonic diverticuli have been recorded in the literature to date. The magnetic resonance imaging (MRI) and pathophysiology of their aetiology have rarely been described. AIM: To report a giant colonic diverticulum along with the MRI of this clinical entity. RESULTS: An 87 year old female presented with symptoms of tenesmus, urgency and alteration in bowel habit. A type I giant colonic diverticulum was diagnosed and a segmental colonic surgical resection was performed. The plain abdominal radiograph, barium enema and MRI, along with classification and management options are presented. CONCLUSION: Giant colonic diverticuli are rare surgical curiosities that may be successfully treated with either primary segmental or extended colonic resection.

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PubMedDate not supplied

Giant colonic diverticulum: a rare manifestation of a common disease.

Giant colonic diverticulum is a rare manifestation of a common disease primarily affecting patients over the age of 50 years. We reviewed all 81 cases of giant colonic diverticulum reported in the medical literature and present herein an additional case in a younger patient. Published reports were summarized with regard to current epidemiology, clinical aspects, diagnosis, pathogenesis, treatment, and complications. Giant colonic diverticulum can present as an acute, chronic, or incidental condition, or with complications. There are several suggested theories for the pathogenesis of giant colonic diverticulum, but none is universally satisfactory. A diagnosis can be made with plain films, barium enema, and CT scans. A combination of sigmoid resection and primary anastomosis was successful in 75% of the cases reported after the mid-1970s. More than 90% of giant colonic diverticula are found in the sigmoid colon. Sigmoid resection with primary anastomosis is the preferred treatment, although patients presenting with complications typically should be treated with Hartmann's procedure for free perforation or percutaneous drainage for a localized abscess. Because of the high risk of complications, we recommend segmental resection of the involved colon for those found incidentally.

Adult↗
PubMed1998

Giant colonic diverticulum: report of four cases and review of the literature.

PURPOSE: Giant colonic diverticulum are rare, with 103 reported cases in 95 patients. The experience of any one surgeon is limited. We aimed to retrospectively review our experience and to review the literature on origin, pathology, and management of this rare and unusual problem. METHOD: Cases were identified by review of pathologic database and by computerized audit from three hospitals. RESULTS: Five giant colonic diverticulum were identified in four patients, and the pathology and management were reviewed. CONCLUSION: A definition and classification system of giant colonic diverticulum is suggested. Giant colonic diverticulum should be the universal term to cover all colonic diverticulum larger than 4 cm, and we suggest that there are two types based on histology. Literature review reveals 103 reported cases in 95 patients. Type I (87 percent) is a pseudodiverticulum, perhaps related to conventional diverticular disease, whereas Type II (13 percent) is a true diverticulum, which is probably a type of communicating cystic congenital duplication. These lesions tend to occur in the sigmoid colon (93 percent) and present with complications similar to conventional diverticular disease. In the presence of conventional diverticular disease, consideration should be given to anterior resection, and in the absence, diverticulectomy should be considered.

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PubMed1999

Giant colonic diverticulum: report of a case.

Giant colonic diverticulum is a rare complication of colonic diverticulosis. It typically occurs as a single diverticulum located on the antimesenteric border of the sigmoid colon. The most widely accepted theory for its development attributes the progressive dilation to a "ball-valve" mechanism, allowing air to enter but not to exit. Patients usually present complaining of abdominal pain and/or an abdominal mass, although they may remain asymptomatic. Physical examination reveals a tympanic abdominal mass that appears as a round radiolucency on plain radiographs and CT. Barium enema demonstrates the relationship of the diverticulum to bowel and may document communication with the colonic lumen. To alleviate symptoms and prevent complications, the recommended treatment is excision of the diverticulum in continuity with the involved colonic segment. We report a case and discuss the presentation, diagnosis, and management of giant colonic diverticulum.

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PubMed1987

CT demonstration of a giant colonic diverticulum.

A case of giant sigmoid colonic diverticulum (GCD) is presented in which plain films showed an unchanging persistent large gas collection that did not opacify on barium enema. The computed tomographic scan revealed the GCD in close apposition to the adjacent sigmoid diverticulosis. Its walls were thin and more irregular than noted on plain films, and there was a suggestion of intraluminal contrast within it.

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PubMed1980

Giant colonic diverticulum.

Five patients with giant colonic diverticulum (GCD) are reported. Three of them had complications of the GCD including free perforation with pneumoperitoneum and peritonitis and an instance of carcinoma arising in a GCD. The preoperative diagnosis of GCD is made radiographically with findings of a large, smoothly marginated, round or oval, homogenous radiolucency in the abdomen that is in close apposition to the colon on barium enema examination. Barium enters the GCD in 60% of the cases. Most GCDs are considered to be pseudodiverticula; however, an occasional case may have all layers of bowel in the wall of the diverticulum and is believed to represent a true diverticulum or a communicating partial colonic duplication.

Adult↗
PubMed2000

Obstructing giant colonic diverticulum.

We report the second case of an obstructing true colonic diverticulum. Of the 103 cases of giant sigmoid diverticulum found in the literature, 13% have been reported as true giant sigmoid diverticulum, ie, containing all layers of the colonic wall. Our 75-year-old patient had clinical symptoms for only 6 months, and endoscopy revealed an almost totally obstructing mass 20 cm from the anus. Surgical resection of the sigmoid colon with a primary anastomosis resolved all of the patient's obstructive symptoms. A flap-valve mechanism was the cause of this true giant colonic diverticulum. Microscopic examination of the diverticulum wall revealed all normal layers of colon wall.

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PubMed1987

CT appearance of giant colonic diverticulum.

The plain film, barium enema, and CT findings in a case of giant colonic diverticulum with the atypical feature of marginal calcifications are presented. The value of CT in the diagnosis and evaluation of giant colonic diverticulum is discussed.

Calcinosis↗
PubMed1999

Mucosal carcinoma within a colonic diverticulum.

We report a case of a mucosal carcinoma and adenoma within a diverticulum in the cecum. Radiographic, endoscopic, and pathologic evaluation of the tumor is presented. Surgical resection was undertaken because of the size and shape of the lesion, risk of perforation, and the possibility of malignancy. A recent review of the literature with respect to clinical signs, diagnosis, growth of the carcinoma, and treatment of tumors around or within diverticula is also presented. A carcinoma or adenoma arising within the diverticulum is very rare. Endoscopic resection of the tumor could entail the risk of perforation, because of the lack of muscular coats in the diverticula. Surgical treatment may be the procedure of choice for lesions near or within the diverticula.

Adenoma↗