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A giant colonic diverticulum presenting as a 'phantom mass': a case report
Ayman S Abdelrazeq1, Anwar E Owais, Munther I Aldoori
1North Cheshire NHS Trust Hospitals, Lovely Lane, Warrington, WA5 1QG, UK. aymonrazeq@yahoo.co.uk.
Journal of Medical Case Reports
|January 29, 2009
Summary
A rare case of giant colonic diverticulum, a large colonic outpouching, mimicked a phantom mass. This condition caused intermittent compression of nerves and veins, highlighting the importance of advanced imaging for diagnosis.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Diagnostic Imaging
Background:
- Diverticulosis coli is a prevalent colon disease in Western nations.
- Giant colonic diverticulum, defined as ≥4 cm, is an uncommon presentation.
- This case highlights a rare manifestation of a common condition.
Purpose of the Study:
- To report a unique case of giant colonic diverticulum.
- To illustrate diagnostic challenges associated with intermittent symptoms.
- To emphasize the role of cross-sectional imaging.
Main Methods:
- Case presentation of a 68-year-old woman with unexplained symptoms.
- Description of extensive, initially non-diagnostic investigations.
- Diagnosis via computed tomography (CT) scan revealing giant colonic diverticulum.
Main Results:
- The 'phantom-mass' was diagnosed as a giant colonic diverticulum.
- The diverticulum caused intermittent compression of the iliac vein and obturator nerve.
- Symptoms included abdominal mass, leg swelling, and neurological deficits.
Conclusions:
- Intermittent compression of iliac vein and obturator nerve by diverticulum is unprecedented.
- Giant colonic diverticulum presenting as an intermittent mass is exceptionally rare.
- Cross-sectional imaging (CT) is crucial for diagnosing intermittent abdominal masses with referred symptoms.
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