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Colonic diverticular abscess presenting as chronic diarrhea: a case report
Nasser Ebrahimi Daryani1, Mohammad Reza Keramati, Peiman Habibollahi
1Department of Gastroenterology, Tehran University of Medical Sciences, Tehran, Iran.
Cases Journal
|January 16, 2010
Summary
Colonic diverticulitis can lead to pelvic abscesses, a rare cause of chronic diarrhea. This case highlights a 72-year-old woman with a large pelvic abscess presenting with refractory diarrhea.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Abdominal Imaging
Background:
- Diverticular disease of the colon is associated with various complications.
- Perforation of colonic diverticula can result in abdominal abscesses with diverse clinical presentations.
Purpose of the Study:
- To report a rare case of a pelvic abscess secondary to colonic diverticulitis.
- To emphasize the varied manifestations of colonic diverticulitis complications.
Main Methods:
- A case report of a 72-year-old woman with a one-month history of non-bloody diarrhea, abdominal pain, and low-grade fever.
- Diagnostic workup included computed tomography (CT) scan revealing a pelvic air-fluid level.
- Surgical intervention via laparotomy identified a large pelvic abscess with rectosigmoid and uterine necrosis.
Main Results:
- Computed tomography scan confirmed a large air-fluid level in the cul-de-sac.
- Laparotomy revealed a significant pelvic abscess compressing the rectosigmoid colon and uterus.
- Severe tissue necrosis of the rectosigmoid colon and uterus was observed.
Conclusions:
- Abdominal abscesses stemming from colonic diverticulitis, though uncommon, can manifest as persistent, refractory chronic diarrhea.
- This case underscores the importance of considering diverticulitis in the differential diagnosis of chronic diarrhea, especially when accompanied by other symptoms and imaging findings.
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