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Not Your Typical Mucocele: A Case Report of a Benign Sigmoidal Diverticular Mucocele
Daniel Alcantar1, Fanny Giron1, Layth Al-Jaashaami2
1Internal Medicine, MacNeal Hospital, Berwyn, USA.
Abstract:
In recent literature, mucoceles have been discovered to be in the appendix vermiformis or in the nasal sinuses. Although rare, colonic mucoceles, as well as rectal mucoceles, have also been encountered. Furthermore, colonic mucoceles arising from a diverticulum is an even more unusual occurrence, and to date, there has been only one reported case. We present a 48-year-old male with a past medical history of multiple episodes of diverticulitis who presented to the emergency department complaining of bilateral lower quadrant abdominal pain for three days. Upon arrival to the emergency department, the patient had a CT scan of the abdomen and pelvis, which showed an annular constricting 65 mm mass in the proximal sigmoid causing large bowel obstruction. The patient underwent unsuccessful endoscopies and inevitably underwent a hand-assisted laparoscopic sigmoid resection. The following days, the biopsy returned and resulted to be a mucocele arising from a sigmoid diverticulum. We encountered the very first benign colonic mucocele arising from a sigmoid diverticulum.
Insights
This study reports the first case of a benign colonic mucocele originating from a sigmoid diverticulum. This rare condition caused a large bowel obstruction in a patient with a history of diverticulitis.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Mucoceles are rare in the colon, with even fewer cases arising from diverticula.
- Previous literature documents only one instance of a colonic mucocele originating from a diverticulum.
Observation:
- A 48-year-old male with a history of diverticulitis presented with abdominal pain and signs of large bowel obstruction.
- CT imaging revealed a sigmoid mass causing obstruction.
- Endoscopic attempts to resolve the obstruction were unsuccessful, necessitating surgical resection.
Findings:
- Histopathological analysis of the resected sigmoid mass confirmed a mucocele arising from a diverticulum.
- This represents the first documented case of a benign colonic mucocele originating from a sigmoid diverticulum.
Implications:
- This case expands the known spectrum of colonic mucoceles.
- Highlights the importance of considering rare diagnoses in patients with diverticulitis and obstructive symptoms.
- Contributes to the understanding of diverticular complications.
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