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 18 June 2018

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GastroenterologyColo-rectum and anus

Diverticular disease

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Diverticulitis of the ascending colon.
A 46-year old man admitted with acute right iliac fossa pain. He was woken at 4 am with pain in the right side of his abdomen. This rapidly got worse and he sought medical help. When seen 12 hours after onset of his symptoms he had right iliac peritonitis and a clinical diagnosis was made of acute appendicitis. At operation, purulent fluid was found in the right iliac fossa. He had a normal (pelvic) appendix and an inflammatory mass affected the posterior aspect of the ascending colon. A limited right hemicolectomy was performed.

The opened specimen showed four diverticula in close proximity to each other on the posterior aspect of the ascending colon, with faecal material plugging the orifice of one. The plug was removed, revealing the underlying necrotic abscess cavity. This photograph shows the ileocaecal valve (A) and the diverticulum (B).


Peter Devitt, Adelaide, Australia

Diverticulitis of the ascending colon.

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