Perforated diverticulitis sigmoidei after laparoscopic cholecystectomy

Area of Science:

• Gastroenterology
• Surgical Case Report

Background:

• Elective laparoscopic cholecystectomy is a common procedure.
• Postoperative pain management often involves non-steroidal anti-inflammatory drugs (NSAIDs).
• Diverticulosis is a common condition, particularly in older adults.

Observation:

• A healthy 47-year-old male developed severe abdominal pain and rebound tenderness post-cholecystectomy despite NSAID analgesia.
• Diagnostic laparoscopy revealed diverticular perforation.
• The patient's condition worsened, requiring emergency sigmoid resection due to suspected fecal material in the drain.

Findings:

• Histopathology confirmed inflammation and perforation in the diverticulosis-affected segment.
• NSAID use was identified as a potential contributing factor to the diverticular perforation and diverticulitis.
• The case highlights a potential adverse effect of NSAIDs on pre-existing diverticulosis.

Implications:

• NSAIDs should be used cautiously in patients with known or suspected diverticulosis.
• Further research may be warranted to elucidate the mechanism of NSAID-induced diverticular complications.
• This case underscores the importance of a thorough patient history regarding diverticular disease before prescribing NSAIDs.