A Case of Multiple Simultaneous Areas of Obstructive Colitis due to Diverticulosis of the Colon

Abstract

A 72-year-old woman was transported to our hospital with a consciousness disorder in the night. Blood tests showed an increased white blood cell count and C-reactive protein and metabolic acidosis. Abdominal CT showed sigmoid colon diverticulitis. Her septic shock did not improve with catecholamine therapy, so emergency laparotomy was performed the next morning. Intraoperative findings included necrosis of the large bowel from the sigmoid colon to the transverse colon. Colectomy of the large bowel from the sigmoid to the transverse colon and end-transverse colostomy were performed. The resected specimen showed diverticulitis of the sigmoid colon and the descending colon, and necrotizing obstructive colitis of the mouth side of each area of diverticulitis. Reports of obstructive colitis due to diverticulitis are rare but are expected to increase in the future with the increasing prevalence of diverticulosis. When examining patients with diverticulitis, it is important to keep in mind the complication of obstructive colitis, especially when stenosis is present.