2021 Volume 41 Issue 1 Pages 29-32
We report a case of infection of a giant diverticulum of the transverse colon that was treated successfully by laparoscopic surgery after failure of previous antibiotic therapy. The patient was a 74-year-old man who was admitted to our hospital with the complaints of fever and abdominal pain. Physical examination revealed a tumor with tenderness to palpation on the right side of the abdomen. Blood tests showed an increase in the levels of inflammatory markers（WBC count 17,200/mm3, CRP 29.3）. Abdominal contrast-enhanced CT revealed a giant diverticulum in the transverse colon measuring 70 mm in diameter. The diverticulum had a thickened wall and a capsule-like structure, suggestive of inflammation of the surrounding fatty tissue. There was no ascites or free air. We made the diagnosis of infection of a giant diverticulum of the transverse colon and started the patient on antibiotic therapy. However, the abdominal pain persisted and we performed laparoscopic transverse colectomy on day 3 after admission. The diverticulum was opened on the side contralateral to the mesenterium. Histopathological examination revealed a pseudo-diverticulum with strong inflammation. Our case report suggests that a giant colonic diverticulum is at a relatively high risk of complications, including diverticulitis, and surgical treatment may be needed for successful treatment.
