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Recurrent, Complicated Diverticulitis With Atypical Features
Shelley Persaud1, Bir Singh1, Francisco Brea1
1Internal Medicine, Medical Center of Trinity, Trinity, USA.
Cureus
|October 20, 2021
Summary
Recurrent complicated diverticulitis requires prompt surgical intervention. This case highlights the importance of consistent outpatient follow-up with general surgery and gastroenterology for managing complex diverticular disease.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Diverticular disease is prevalent in Western populations, encompassing conditions from asymptomatic diverticulosis to complicated diverticulitis.
- Complicated diverticulitis presents significant healthcare costs and management challenges.
Observation:
- A unique case of recurrent, complicated diverticulitis in a 62-year-old male is presented.
- The patient experienced six hospitalizations within one year for diverticulitis, complicated by sealed perforation, abscesses, and colocutaneous fistulas.
- Despite recommendations, the patient did not attend recommended outpatient follow-ups with general surgery or gastroenterology.
Findings:
- Imaging revealed diverticulitis in the distal descending and proximal sigmoid colon.
- The patient ultimately required an elective sigmoid colectomy with takedown of colocutaneous fistulas.
- The case underscores atypical presentations of diverticulitis.
Implications:
- Highlights the critical role of consistent outpatient follow-up in managing complex diverticular disease.
- Discusses criteria for prophylactic colon resection in recurrent or complicated diverticulitis.
- Emphasizes the need for timely surgical and gastroenterological consultation to prevent severe complications.
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