2025 Volume 45 Issue 7 Pages 631-635
The patient was a woman in her 50s who presented to us with a 6-month history of left lower back pain. The symptom had gradually worsened over time, with the patient additionally developing a high fever and pain and swelling of the left thigh, eventually becoming unable to stand. Blood tests revealed elevated inflammatory markers (WBC 18,770/μL, CRP 21.7mg/dL). Contrast-enhanced abdominal CT revealed an abscess extending from the left lower back to the thigh. On the same day, we performed an emergency laparoscopic colostomy (transverse colon) and incision-drainage of the left thigh abscess as we suspected perforation of the sigmoid colon. A subsequent lower gastrointestinal endoscopy confirmed sigmoid colon diverticulum perforation. The patient was discharged on postoperative day 48. Six months after the initial surgery, we performed sigmoid colon resection, colostomy closure, and ileostomy (covering stoma). A further six months later, ileostomy closure was carried out. The patient was discharged on postoperative day 10 without complications. Since the abdominal symptoms were initially mild, further delay in the diagnosis could have led to a fatal outcome. Prompt colostomy and abscess drainage are essential for treatment.
