A 53-year-old female was admitted to this hospital because of a painful abdominal mass and leukocytosis. Physical examination on admission revealed a painful mass of the right lower quadrant. Initial laboratory data included a white blood cell count of 13,600 mm3 and a CRP of 12.2mg/dl. She was given intravenous fluids, and placed on antibiotic therapy. As clinical observations and laboratory data pointed to inflammation of the right-sided colon, ultrasonography and CT scanning suggested a penetrating carcinoma of the ascending colon. Barium enema revealed narrowing of the ascending colon with“accordion sign”. Colonoscopy disclosed an edematous elevated lesion, 5cm long, without ulceration. The biopsy specimens revealed colitis. On the 9th hospital day there was no palpable abdominal mass and she denied tenderness on physical examination. On the 15th hospital day the elevated lesion decreased in size and obvious diverticula of the ascending colon were noted on colonoscopy. In this case the endoscopic examination was helpful for the definite diagnosis of deverticulitis.
