"Sigmoid diverticulitis mimicking cholecystitis" a clinical challenge.

Area of Science:

• Gastroenterology
• Diagnostic Imaging

Background:

• Diverticular disease is a prevalent condition, with incidence rising with age.
• Pathophysiology is multifactorial, influenced by lifestyle (smoking, alcohol, diet, physical activity) and genetics, particularly for right-sided diverticular disease (RSD).
• Most patients are asymptomatic; however, diverticulitis presents with abdominal pain and other symptoms, posing diagnostic challenges, especially when affecting the ascending colon.

Purpose of the Study:

• To report a case of sigmoid colon diverticulitis presenting as right upper quadrant pain, initially suspected as cholecystitis.
• To underscore the diagnostic utility of ultrasound (US) and Computed Tomography (CT) in identifying atypical presentations of diverticular disease.

Main Methods:

• Case report of a 70-year-old female presenting to the Emergency Department (ED) with right upper quadrant pain.
• Initial clinical suspicion of cholecystitis.
• Diagnostic imaging including ultrasound (US) and Computed Tomography (CT) were utilized.

Main Results:

• Ultrasound and CT revealed sigmoid colon diverticulitis with an anatomical variation.
• The patient's presentation mimicked other acute abdominal emergencies, highlighting a diagnostic challenge.

Conclusions:

• Ultrasound serves as a crucial first-step diagnostic tool for acute abdominal conditions.
• Combined use of ultrasound and CT enhances diagnostic accuracy for complex cases like atypical diverticular disease.