2022 Volume 64 Issue 8 Pages 1475-1481
A 62-year-old woman was hospitalized twice previously for fecal ileus, which improved using conservative treatment. She was transferred to our hospital as an emergency for evaluation of left abdominal pain. Abdominal radiography revealed a niveau image, and abdominal computed tomography showed a fecal mass in the descending colon, with significant fecal retention and expansion on the oral side. Colonoscopy showed fecaliths in the descending colon without any tumorous changes and stenosis. We observed fecal discharge after fecalith removal; therefore, the patient was diagnosed with fecal ileus. Gastrointestinal contrast-enhanced imaging performed on the 8th day after admission revealed a giant colonic diverticulum, and the patient underwent laparoscopic descending colectomy. Histopathological examination of the resected specimen revealed fibrous thickening of the muscular layer of the diverticulum wall, suggestive of a true diverticulum. The possibility of a giant colonic diverticulum should be considered in patients with recurrent fecal ileus.
