Diverticulitis: Large Bowel Obstruction

Abstract

Recurrent diverticulitis had been diagnosed 15 years previously, and mild episodes, always responding to antibiotic therapy, continued during this period. The patient presented with a 4-week history of lower abdominal colicky pain, constipation, and rectal bleeding on 1 occasion. A firm pelvic mass was present on rectal examination. A short colonoscopy was performed with the small caliber panendoscope, and a tight sigmoid stricture was negotiated, establishing the diagnosis of sigmoid diverticulitis. A cautious contrast enema showed dilatation of the colon above the stricture and no pathology in the proximal colon (Figure 48.1). Within a few weeks, the patient developed further severe pain, nausea, and vomiting. Operation was expedited.