A Case of Obstructive Colitis Caused by Sigmoid Colon Stenosis due to Chronic Diverticulitis

Abstract

A 61-year-old man was hospitalized with a head injury and was bedridden after craniotomy. After starting to eat, constipation and abdominal pain persisted, followed by worsening abdominal pain and decreased blood pressure. Blood tests showed an increased inflammatory response and metabolic acidosis, computed tomography showed multiple diverticula and wall thickening on the distal sigmoid colon, and the colon on the oral side was markedly dilated from the same part. Since intestinal obstruction due to tumor was suspected, colonoscopy was performed for decompression. Obstructive colitis caused by stenosis due to sigmoid diverticulitis was diagnosed, and emergency surgery was performed. The distal sigmoid colon was mass-like, stiff, and shortened, and the descending colon and the proximal sigmoid colon had turned dark red and edematous. A left hemicolectomy was first performed, erosion and ulceration were found at the stump, right hemicolectomy and partial ileal resection were added, and an end stoma was constructed in the ileum. Although obstructive colitis caused by diverticulitis of the colon is rare, the number of cases of left-sided colon type chronic diverticulitis is increasing due to aging. It is necessary to consider diverticulitis as a cause of obstruction.