A Case of Giant Diverticulum of Ascending Colon with Repeated Fecal Stone Intestinal Obstruction

Abstract

An 82-year-old man presented to our hospital with recurrent lower abdominal pain due to an ascending giant colonic diverticular fecal stone after endoscopic coprolite disruption. Abdominal computed tomography (CT) showed a 60 mm long marginal ring-shaped calcified lesion near the ileum, along with luminal trafficking in the ascending colon. The patient had a history of peritonitis after an open gastrectomy. Severe adhesion was expected ; however, laparoscopic ileocecal resection was performed. The patient was discharged 9 days after surgery without any complications. Histopathological examination revealed that the diverticular wall had a defect in the muscular layer, and a pseudodiverticulum was diagnosed. Diverticulosis is generally defined as a diverticulum of > 40 mm in diameter. We report this rare case along with a review of 20 Japanese cases from the literature.