Giant colonic diverticulum: percutaneous computed tomography-guided treatment

Area of Science:

• Gastroenterology
• Interventional Radiology
• Surgical Oncology

Background:

• Giant sigmoid diverticula are rare and can lead to severe diverticulitis.
• Traditional treatment often involves staged surgical resection, including a Hartmann procedure with end colostomy.
• Minimally invasive options are sought to reduce morbidity.

Observation:

• A case of inflamed giant sigmoid diverticulum is presented.
• Computed tomographic (CT) guidance was utilized for the intervention.
• The procedure involved dilation of the diverticulum's neck and decompression.

Findings:

• An internal stent was placed across the diverticulum's neck to maintain decompression into the sigmoid colon.
• This intervention successfully managed the acute episode of diverticulitis.
• Recurrence was prevented by maintaining decompression.

Implications:

• Percutaneous CT-guided intervention offers a viable alternative for treating inflamed giant colonic diverticula.
• This approach may help avoid the need for a staged Hartmann procedure and end colostomy.
• Minimally invasive techniques can improve patient outcomes in complex diverticular disease.