A Case of Surgical Resection for Diverticulitis of the Sigmoid Colon with Obstruction

Hideaki Motohashi, Mitsuru Obata, Shingo Morimoto, Shunsuke Kato, Takashi Kuwayama, Naoko Okamoto, Takao Ishida and Kenichi Sugihara*

Department of Surgery, Nakano General Hospital
Colorectal Surgery Division, Tokyo Medical and Dental University Graduate School of Medicine*

We report a case of surgical resection for diverticulitis of the sigmoid colon associated with obstruction. An 86-year-old woman reporting sudden abdominal pain was admitted with ileus diagnosed by abdominal X-P. Gastrographin examination showed stenosis of the sigmoid colon, and abdominal computed tomography a thickened wall with edema and diverticulitis. Based on these findings, she was diagnosed with ileus resulting from diverticulitis. There were no abdominal findings in colonoscopy 25 cm from the anal verge. She underwent subtotal colectomy due to dilation of the oral side of the colon. The resected specimen revealed stenosis for 6cm in the sigmoid colon due to thickening of the wall. Pathological examination revealed normal mucosa, thickening of the muscular layer, and the infiltration of inflammatory cells. Based on these findings, we diagnosed the cause of stenosis as wall thickening due to diverticulitis and edematous changes. No malignancy was seen. Despite the many complications of diverticulitis, stenosis requiring surgery is rare. We report this case together with a discussion of the diverticulitis literature.

Key words
diverticulitis, bowel obstruction

Reprint requests
Hideaki Motohashi Department of Surgery, Nakano General Hospital
4-59-16 Chuuou, Nakano-ku, Tokyo 164-0011 JAPAN

Accepted
June 30, 2004

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