Annular Extramural Dissecting Diverticulitis

Abstract

The patient had undergone laparotomy for a “diverticular abscess” 16 years previously, but details were not available. The present illness commenced with pain in the left iliac fossa 6 weeks previously and was accompanied by diarrhea and abdominal distention. A tender mass was present in the left iliac fossa (LIF) that was also palpable on rectal examination. The pelvic floor was subtle on palpation, indicating it was not involved. Colonoscopy was limited by a stricture in the sigmoid colon. There was no endoscopic evidence of malignancy. A limited barium enema demonstrated a stricture of the mid sigmoid colon with obstruction proximal to it (Figure 45.1). There was mucosal continuity within the stricture, suggesting it was inflammatory.