Article

Giant colonic diverticula. Review of diagnostic and therapeutic options.

Department of Surgery, Rijnland Hospital, Leiderdorp, The Netherlands.
Digestive Surgery (Impact Factor: 1.74). 02/2004; 21(1):1-6; discussion 6. DOI: 10.1159/000074833
Source: PubMed

ABSTRACT 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.

0 Bookmarks
 · 
67 Views
  • Source
    Journal of Medical Case Reports 08/2014;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Q Resumen Informamos sobre el caso de un hombre de 67 años de edad con presencia de un divertículo colónico gigante asociado a múltiples co-mor-bilidades. La presentación clínica inusual y el alto ries-go quirúrgico requirieron de decisiones complejas que motivaron una resección co-lónica con procedimientos complementarios a pesar que se había rechazado el tratamiento quirúrgico por dos grupos quirúr-gicos diferentes. Se realizó una revisión de los úl-timos diez años la literatura utilizando las bases de datos Medline y Pubmed en los idiomas inglés y español con las palabras clave: " divertículo co-lónico gigante " . Se encontraron 43 informes de casos, una serie de casos y un artículo de revisión que incluía 135 casos. En la discusión comenta-mos la información obtenida de la bibliografía y los aspectos particulares de este interesante caso. Q Abstract We report about a 67 year-old male patient with a giant colonic diverticulum and multiple comorbid con-ditions. The unusual clini-cal presentation and high surgical risk in this case required challenging thera-peutic decisions that even-tually lead to a left colon re-section and complementary surgical procedures, despite the patient had been considered non-surgical candidate by two surgical teams before. A literature review from the last ten years was performed using Medline and Pubmed databases, looking for " giant colonic diverticu-lum " . We found 43 case reports, one case series and one review article including 135 patients. Dis-cussion is based on the information obtained from the literature review and the particular aspects of this interesting case. Palabras clave:
    Revista de gastroenterologia de Mexico 01/2010; 2(75):213-217.
  • Source
    [Show abstract] [Hide abstract]
    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.