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CC BY-NC-ND 4.0 · Journal of Coloproctology 2022; 42(02): 173-177
DOI: 10.1055/s-0042-1749102
Review Article

Giant Colonic Diverticulitis, an Extremely Rare Presentation of a Rare Disease — Clinical Presentation and Literature Review

Eliahu Y. Bekhor 
1   Department of Surgery, Rabin Medical Center, Petah Tikva, Israel
,
Ran Orgad 
1   Department of Surgery, Rabin Medical Center, Petah Tikva, Israel
,
Hila Shmilovitch 
1   Department of Surgery, Rabin Medical Center, Petah Tikva, Israel
,
Rotem Ayalon 
2   Division of Trauma and Acute Care Surgery, Rabin Medical Center, Petah Tikva, Israel
,
Oleg Kaminsky 
2   Division of Trauma and Acute Care Surgery, Rabin Medical Center, Petah Tikva, Israel
› Author Affiliations Funding None.
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Abstract

Introduction Giant colonic diverticulum (GCD) is rare phenomenon, with less than 200 cases described in the literature. One of the complications of GCD is diverticulitis. To date, there is paucity of data addressing the diagnosis and management of GCD complicated by acute diverticulitis.

Objective To better understand the diagnostic tools, the initial management, and the long-term follow-up for this group of patients as well as to recommend a proper multidisciplinary approach to this infrequent disease.

Method A systematic literature search was performed using the PubMed, Embase, and Cochrane databases to identify all the published studies on GCD complicated by diverticulitis. Two of the authors assessed the relevance of the included full-text papers. The articles were assessed independently.

Results In total, 12 cases were identified. Our results show that 10/11 (91%) of the patients who had computed tomography (CT) scans during the initial evaluation had a correct diagnosis. There was no case of failure to non-operative approach (7/7). The patients who had an emergency operation were treated so due to diffuse peritonitis (two patients), acute hemorrhage arising from ulcers within the diverticula (one patient), and misdiagnosis (one patient).

Conclusion Giant colonic diverticulitis is a very rare disease. Computed tomography scan is a valuable tool for the initial diagnosis as well as for treatment strategy planning. Non-operative management is a viable option for patients without diffuse peritonitis. Interval endoscopy is recommended if no contraindication exists.

Keywords

giant colonic diverticulum - giant colonic diverticulitis - colon cancer


Publication History

Received: 09 December 2021

Accepted: 11 April 2022

Article published online:
15 June 2022

© 2022. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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