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[Brain abscess in retroperitoneal perforated colonic diverticulitis]
H Helfritzsch1, S Seifert, O Sölch
1Klinik für Allgemeine und Viszerale Chirurgie, Universität Jena. Helfritzsch@med.uni-jena.de
Abstract:
The most frequent complications in diverticular disease are local abscess, perforation with peritoneal sepsis, fistula and ileus. Extraabdominal manifestation is an actual rarity. A haematogenous bacterial spread via portal vein with formation of liver abscess has seldom been described. But a complicated diverticular disease as a cause for a brain abscess is an absolute rarity. Our case presents a patient with brain abscess caused by asymptomatic, retroperitoneal perforated colonic diverticulosis. We discuss diagnostic steps both in diverticular disease and brain abscess and different surgical options in the treatment of colonic complicated diverticular disease.
Insights
Brain abscesses are rare complications of diverticular disease. This case highlights a brain abscess originating from an asymptomatic, perforated colonic diverticulosis, emphasizing rare extra-abdominal manifestations.
Area of Science:
- Gastroenterology
- Neurology
- Infectious Diseases
Background:
- Diverticular disease commonly presents with local complications like abscess, perforation, fistula, or ileus.
- Extra-abdominal manifestations of diverticular disease are infrequent.
- Hematogenous spread causing liver abscess is rare; brain abscess is exceptionally rare.
Observation:
- A patient developed a brain abscess.
- The cause was asymptomatic, retroperitoneal perforated colonic diverticulosis.
- This represents an extremely rare extra-abdominal complication.
Findings:
- The study details a unique case of brain abscess secondary to undiagnosed colonic diverticulosis.
- Diagnostic strategies for both diverticular disease and brain abscess were reviewed.
- Surgical management options for complicated colonic diverticular disease were discussed.
Implications:
- This case underscores the importance of considering rare etiologies for brain abscesses.
- It highlights the potential for severe, unexpected complications from seemingly asymptomatic diverticular disease.
- Early diagnosis and appropriate surgical intervention are crucial for managing such rare presentations.