Diverticula of the colon versus gallstones
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A case of diverticulosis of the colon is presented with an unusual location of the diverticula. The barium filled diverticula projected their shadows at the site of the gallbladder region.
These shadows appeared in the shape, size, location, constellation, including even certain ringshape formation of the characteristic x-ray picture of gallstones. Subsequent films, on close inspection, revealed certain changes inconsistent with gallstones, but easily explainable by diverticular sacculations.
Patient suffered, incidentally, from a superimposed cholelithiasis, too, as evidenced by the typical history and the failure to visualize the gallbladder and its contents by the routine method of cholecystography.
The projected gallstone-like shadows on first impression might have been conducive to be considered gallstones, responsible for the recurring severe biliary attacks. However, these shadows proved to be bariumfilled diverticular sacculations, which their shadows projected at the gallbladder region, while the gallstones, responsible for the attacks, being non-opaque and invisible to x-rays, failed to be visualized and consequently demonstrable through x-rays.
Various coincidental factors created a diagnostic puzzle and perplexity. Their proper recognition and interpretation, however, enabled the establishment of an early and correct diagnosis.
KeywordsBarium Cholelithiasis Hepatic Flexure Colonic Diverticulum Benign Gastric Ulcer
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