2017 Volume 42 Issue 6 Pages 957-963
We report 2 patients with intramesenteric penetration of colon diverticulitis. Patient 1 was a 52-year old male. He visited our hospital with chief complaints of hypogastrium pain and fever. His physical finding revealed rebound tenderness of lower abdomen. Judged from abdominal CT showing intramesenteric air of sigmoid colon, he was diagnosed as intramesenteric penetration of sigmoid colon diverticulitis. First, we performed conservative therapy, considering peritonitis was localized and the hemodynamics was stable. On 17th day after admission, his clinical symptom got worse and abdominal CT showed enlarged abscess including air in mesentery of sigmoid colon. We conducted Hartmann’s operation. Intramesenteric penetration of sigmoid colon was recognized from the removed specimens. Patient 2 was a 55-year old female. She visited our hospital with a chief complaint of hypogastrium pain. Her physical finding showed rebound tenderness of lower abdomen, and abdominal CT revealed a low density area including air bubble in mesenterium of sigmoid colon and rectosigmoid colon. We emergently performed Hartmann’s operation on diagnosis of intramesenteric penetration of sigmoid colon diverticulitis. We identified intramesenteric penetration of rectosigmoid colon and extensive abscess extending from subserosa to muscularis propria on the resected specimens.
