Abstract
A colonic diverticulitis, which is rarely experienced during childhood, requires differential diagnosis with an acute abdomen, such as an acute appendicitis. We present a case of pediatric diverticulitis of the ascending colon diagnosed by the dynamic CT and treated by simple diverticulum excision. An 11-year-old girl complained of right lower abdominal pain. An ultrasonography revealed 40 × 30 mm size of low echoic lesion, with a fecalith-like structure in her lower right abdomen; findings suspected of periappendiceal abscess. Dynamic CT showed 50 × 30 mm size of tumor like lesion containing a fecalith at the mesentery side of the lower ascending colon with no swelling of the appendix. An urgent operation was performed under the diagnosis of ascending colon diverticulitis. Excision of diverticulum, including the surrounding granular tissue, was performed for a greenish yellow fecalith embedded in the membrane of intestinal tract. The postoperative course was uneventful, and was followed by barium enema 2 months after operation. Dynamic CT seemed to be useful for the diagnosis of colonic diverticulitis. Simple diverticulum excision is considered to be sufficient enough for patients with this disease, and intestinal tract excision should be avoided in a cases of solitary diverticulitis.
