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J Med Case Rep. 2010 Oct 18;4:324. doi: 10.1186/1752-1947-4-324.

Giant sigmoid diverticulum with coexisting metastatic rectal carcinoma: a case report.

Author information

  • 1Department of Surgery, Louth County Hospital, Dundalk, Co Louth, Ireland. wsasi2003@yahoo.co.uk.

Abstract

INTRODUCTION:

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.

CASE PRESENTATION:

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.

CONCLUSION:

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.

PMID:
20955549
[PubMed]
PMCID:
PMC2967567
Free PMC Article

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