2018 Volume 60 Issue 9 Pages 1579-1584
A 66-year-old woman was admitted to our hospital because of right flank pain of about two months’ duration. Her past medical history revealed that there were multiple episodes of ascending colon diverticulitis since the patient was in her 40s, but each episode of diverticulitis was relieved with conservative treatment. Abdominal computed tomography revealed intestinal obstruction due to thickened wall of the terminal ileum. Colonoscopy showed right-sided diverticular disease, and the terminal ileum was narrowed and it was impossible to insert a scope, but no malignant findings were observed in the mucosa of the ascending colon and ileocecal region. Significant stenotic findings were noted in the above-mentioned examinations. Since malignancy could not be completely ruled out, ileocecal resection was performed. Examination of the resected specimen revealed diverticular disease of the ascending colon and stenosis of 3cm in length near the ileocecal valve due to thickening of the terminal ileum. On pathological examination, fibrosis around the diverticula and muscle layer thickening were noted in the ascending colon. The stenosis of the terminal ileum was caused by fibrosis of the submucosal and the subserosal layers. Fibrosis was observed continuously from the ascending colon to the terminal ileum. No malignancy was seen.
Among cases of diverticulosis with stenotic symptoms, there are many case reports of stenosis accompanying diverticular disease of the sigmoid colon. However, right-sided diverticular disease with ileocecal obstruction has rarely been reported. We report this case together with a literature review.
