1st Surgical Department, Laiko General Hospital, Athens, Attica, Greece
1st Surgical Department, Laiko General Hospital, Athens, Attica, Greece.
BMJ Case Rep. 2024 Jan 31;17(1):e254703. doi: 10.1136/bcr-2023-254703.
Diverticulitis in a solitary transverse colon diverticulum is uncommon, with only a handful of cases documented in the literature. There are various clinical manifestations of the disease, which make clinical and radiological diagnosis rather challenging. Herein, we present a case of a premenopausal female patient in her late 40s who presented to the emergency department, complaining of right lower quadrant abdominal pain, nausea, anorexia and fever. Following clinical, biochemical and radiological tests, the patient was prepared for surgical operation, with the presumed diagnosis of acute appendicitis. An appendicectomy was planned via a McBurney incision. Notably, no inflammation of the appendix was discovered. However, on further exploration, an inflammatory mass was identified in the transverse colon, which was subsequently excised and sent for histological examination. The histology results confirmed the presence of a ruptured solitary transverse colon diverticulum, accompanied by an adjacent mesenteric abscess. The patient's postoperative recovery was uneventful.
孤立性横结肠憩室炎并不常见,文献中仅记载了少数几例。该病有多种临床表现,这使得临床和影像学诊断颇具挑战性。本文报告了 1 例 40 多岁的绝经前女性患者,因右下腹痛、恶心、食欲不振和发热就诊于急诊科。经过临床、生化和影像学检查,患者准备接受手术治疗,初步诊断为急性阑尾炎。计划通过 McBurney 切口行阑尾切除术。值得注意的是,并未发现阑尾有炎症。然而,进一步探查发现横结肠有一处炎症性肿块,随后将其切除并送检组织学检查。组织学结果证实存在破裂的孤立性横结肠憩室炎,伴相邻肠系膜脓肿。患者术后恢复顺利。