Abstract
Introduction Giant colonic diverticulum (GCD) is rare phenomenon, with less than 200 cases described
in the literature. One of the complications of GCD is diverticulitis. To date, there
is paucity of data addressing the diagnosis and management of GCD complicated by acute
diverticulitis.
Objective To better understand the diagnostic tools, the initial management, and the long-term
follow-up for this group of patients as well as to recommend a proper multidisciplinary
approach to this infrequent disease.
Method A systematic literature search was performed using the PubMed, Embase, and Cochrane
databases to identify all the published studies on GCD complicated by diverticulitis.
Two of the authors assessed the relevance of the included full-text papers. The articles
were assessed independently.
Results In total, 12 cases were identified. Our results show that 10/11 (91%) of the patients
who had computed tomography (CT) scans during the initial evaluation had a correct
diagnosis. There was no case of failure to non-operative approach (7/7). The patients
who had an emergency operation were treated so due to diffuse peritonitis (two patients),
acute hemorrhage arising from ulcers within the diverticula (one patient), and misdiagnosis
(one patient).
Conclusion Giant colonic diverticulitis is a very rare disease. Computed tomography scan is
a valuable tool for the initial diagnosis as well as for treatment strategy planning.
Non-operative management is a viable option for patients without diffuse peritonitis.
Interval endoscopy is recommended if no contraindication exists.
Keywords
giant colonic diverticulum - giant colonic diverticulitis - colon cancer
