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A diverticular 'pain in the bottom'
Suchi K Bardhan1, Emma Morgan, Ian R Daniels
1Department of Colorectal Surgery, John Radcliffe Hospital, Oxford, UK.
Annals of the Royal College of Surgeons of England
|July 13, 2006
Summary
Diverticular disease rarely presents as a gluteal abscess without gastrointestinal symptoms or a clear abdominal connection. This unusual case underscores the need for high clinical suspicion when typical diverticulitis signs are absent.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Diverticular disease typically involves colonic inflammation.
- Abscess formation is a known complication, usually intra-abdominal or pelvic.
Observation:
- A 40-year-old male presented with a gluteal abscess as the initial manifestation.
- Imaging showed no discernible tract connecting the abscess to the abdominal cavity or retroperitoneum.
- The patient exhibited no gastrointestinal symptoms.
Findings:
- This case represents an atypical presentation of diverticular disease.
- The gluteal location and absence of a connective tract are highly unusual.
- Lack of typical gastrointestinal symptoms further complicated diagnosis.
Implications:
- Highlights the importance of considering diverticular disease in unusual abscess locations.
- Emphasizes the need for a high index of clinical suspicion beyond classic diverticulitis indicators.
- Suggests that imaging may not always reveal a direct connection in rare presentations.