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.

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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.
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