Sigmoid diverticulitis mimicking colorectal cancer: A case report

Sigmoid diverticulitis is a common gastrointestinal condition, but presentation with intestinal obstruction closely resembling colorectal malignancy is rare and poses a significant diagnostic challenge, particularly in resource-limited settings. A 56-year-old man presented with progressive abdominal distension, feculent vomiting, and intermittent rectal bleeding, and computed tomography demonstrated features of large bowel obstruction at the sigmoid colon suspicious for malignancy. Emergency laparotomy with oncologic resection was performed, and histopathological analysis confirmed benign sigmoid diverticulitis without evidence of cancer. This case highlights the substantial diagnostic overlap between diverticulitis and colorectal malignancy on imaging, underscoring the limitations of radiology alone in distinguishing benign from malignant disease. Histopathological confirmation remains essential to guide definitive management, and adherence to oncologic surgical principles ensures safe outcomes when malignancy cannot be excluded preoperatively, especially in low-resource settings.