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Giant sigmoid diverticulum.

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Giant colonic diverticulum, a rare condition, can grow significantly over time. This case highlights a 20cm sigmoid diverticulum causing severe complications, ultimately leading to palliative care.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Radiology

Background:

  • Giant colonic diverticulum is an uncommon condition, defined by diverticula larger than 4 cm, typically affecting the sigmoid colon.
  • Diagnosis is usually made via CT of the abdomen and pelvis (CTAP).
  • Surgical resection with primary anastomosis is the preferred treatment, though Hartmann's procedure is an option for complicated cases.

Purpose of the Study:

  • To present an atypical case of a giant sigmoid diverticulum with significant growth and complications.
  • To discuss the diagnostic and therapeutic challenges posed by such a large diverticulum.

Main Methods:

  • Case report of a symptomatic patient with a giant sigmoid diverticulum.
  • Initial diagnosis via CT of the abdomen and pelvis (CTAP).
  • Longitudinal observation of diverticulum growth and symptom progression over six years.

Main Results:

  • An incidental 6 cm sigmoid diverticulum was initially identified.
  • Over six years, the diverticulum enlarged to 20 cm.
  • The giant diverticulum caused gastric compression, left hemidiaphragm splinting, and nutritional failure.

Conclusions:

  • Giant colonic diverticula can grow substantially, leading to severe complications.
  • Symptomatic management and palliative care may be necessary when curative surgery is not feasible due to patient frailty and complications.