Giant Colonic Diverticula

Leiden University, Leyden, South Holland, Netherlands
Digestive Surgery (Impact Factor: 2.16). 02/2004; 21(1):1-6; discussion 6. DOI: 10.1159/000074833
Source: PubMed


A rare complication of diverticulosis of the colon is giant colonic diverticula (GCD). The condition was first described in English literature in 1953.
A Medline search was undertaken for English, French and German language articles on 'giant colonic diverticula'.
A total of 135 patients were identified, presenting with a total of 155 GCD. With a complication rate of 28% and an operative mortality of 5%, GCD seems to have a high clinical significance. Radiological examination of choice seems to be plain abdominal X-ray and CT examination, barium enema carries the risk of perforation of the diverticulum, and should not be performed.
There are different therapeutic options, in our opinion diverticulectomy alone is not the treatment of choice. Because of the possibility of recurrence and oncological reasons, colectomy seems to be the best treatment. The creation of a protecting colostomy depends on other operative findings.

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    • "The ostium between the diverticulum and the colon is frequently too small to be detected [7-9]. GCD cases that have spontaneously resolved with conservative treatment have been reported; nevertheless, the gold standard of management of a GCD is a surgical resection and a primary anastomosis to exclude an underlying malignancy because adenocarcinomas arising from GCDs have been reported previously [9]. "
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    ABSTRACT: Diverticular disease of the colon is a common disease, and its incidence is increasing gradually. A giant colonic diverticulum (GCD) is a rare entity and is defined as a diverticulum greater than 4 cm in size. It mainly arises from the sigmoid colon, and possible etiology is a ball-valve mechanism permitting progressive enlargement. A plain abdominal X-ray can be helpful to make a diagnosis initially, and a barium enema and abdominal computed tomography may confirm the diagnosis. Surgical intervention is a definite treatment for a GCD. We report a case of an ascending GCD presenting with intussusception in a young adult.
    Annals of Coloproctology 10/2013; 29(5):209-212. DOI:10.3393/ac.2013.29.5.209
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    • "The etiology of GDC is not clearly understood, although in over 90% of reported cases there has been associated colonic diverticulosis [2]. Histologically, there are three described types of GDC, namely the true congenital diverticulum, where the wall has all the colonic structural layers, the pseudo-diverticulum, where the wall is mainly composed of mucosa, and the inflammatory GDC, where the wall is only a reactive scar tissue. "
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    ABSTRACT: Giant diverticulum of the colon is a rare but clinically significant condition, usually regarded as a complication of an already existing colonic diverticular disease. This is the first report of a giant diverticulum of the colon with a co-existing rectal carcinoma. We report a case of a 66-year-old Caucasian woman who presented with lower abdominal pain, chronic constipation and abdominal swelling. Preoperative abdominal computed tomography revealed a giant diverticulum of the colon with a coexisting rectal carcinoma and pulmonary metastasis revealed on a further thoracic computed tomography. An en bloc anterior resection of the rectum along with sigmoid colectomy, partial hysterectomy and right salpingoophorectomy was subsequently performed due to extensive adhesions. This report shows that the presence of a co-existing distal colorectal cancer can potentially lead to progressive development of a colonic diverticulum to become a giant diverticulum by increasing colonic intra-luminal pressure and through the ball-valve mechanism. This may be of interest to practising surgeons and surgical trainees.
    Journal of Medical Case Reports 10/2010; 4(1):324. DOI:10.1186/1752-1947-4-324
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    Revista de gastroenterologia de Mexico 76(1):48-49.
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