A Phantom of the Large Bowel.

Area of Science:

• Gastroenterology
• Colorectal Surgery

Background:

• Giant colonic diverticulum (GCD) is defined as a colonic diverticulum exceeding 4 cm in diameter, typically found in the sigmoid colon.
• While often asymptomatic, GCD can manifest as an abdominal mass or diarrhea.

Observation:

• Acute diverticulitis is an uncommon presentation for GCD.
• This report details a middle-aged patient whose initial presentation of GCD was severe acute diverticulitis.

Findings:

• The patient presented with sepsis secondary to acute diverticulitis, which was the first recognized sign of an underlying GCD.
• This case underscores the potential for severe complications in GCD, even without prior typical symptoms.

Implications:

• Highlights the importance of considering GCD in patients with acute diverticulitis, especially when severe.
• Suggests that acute diverticulitis can be the primary clinical manifestation of GCD, necessitating prompt diagnosis and management.
• Emphasizes the need for awareness among clinicians regarding the varied presentations of GCD.