Giant colon diverticulum - rare condition: case report

Introduction: Large intestine diverticulosis refers to the presence of diverticula in the colon, mostly located in the sigmoid colon. A rare condition that affects patients with colonic diverticulosis is the giant colonic diverticulum (GCD), which has a diameter of over 4 cm. The giant colonic diverticulum affects men and women equally, achieving highest incidence in groups between 35 and 90 years old (average 65 years) and is usually located on the antimesenteric border of the sigmoid colon in 90% of cases. Objective: report a case of giant colonic diverticulum diagnosed in a 76-year-old patient and describe the clinical signs and symptoms, laboratory tests, radiological findings and the therapeutic conduct performed. Methods: This is a case report, using personal data and medical information collected from the analysis of the medical record, gathering information such as demographic data, initial clinical presentation, progression, and patient outcome Results: On abdominal physical examination presented palpable mass in the hypogastric region and pain located in the hypogastric and periumbilical region with irradiation to the left iliac fossa, and without visceromegaly. In the blood count, presented discreet leukocytosis with and neutrophilia and the function tests and liver and kidney profile were within the reference. The convenctional radiography showed a rádio transparent finding of well-defined contours (balloon signal) in the hypogastric region. The computed tomography of the abdomen demonstrated diverticular disease of the sigmoid colon and a smooth and regular cystic cavity with air/gas level, measuring 7.4 cm in diameter, located in the hypogastric region. In view of the clinical and imaging evidence, diverticulitis and GCD were diagnosed. The inflammatory symptoms combined with alternative therapy based on conservative treatment, with no need for resection of the adjacent colon, are configured in a conduct of satisfactory value, in this specific case. Conclusions: The clinical presentation of GCD may remain asymptomatic for months or even years, produce nonspecific abdominal discomfort or manifest in the form of an acute abdomen. In view of the characteristics of the case, the scarce references in the world literature and because it details the conduct and follow-up of the patient affected by this disease, it is opportune to describe it.