Colonic diverticulosis 1 (descending colon)
Author: Prof. em. Dr. med. S. Liebe, University Hospital Rostock, Rostock, Germany
From: Falk Media Service D34, Endoscopy Practice on Video - Selected Diseases of the Colon
2. Edition 2012. © Falk Foundation e.V. All rights reserved.
This is a 64-year-old white female patient, who, over a period of several years, complained of crampy pain in the lower left abdominal quadrant. She had never observed blood in the stool and would not consent to further work-up. Laboratory values were always within normal limits. The current ultrasound examination of the abdomen revealed a thickening of the wall of the sigmoid colon and raised the suspicion of a sigmoid diverticulum. Colonoscopy was performed in order to rule out malignant disease.
The video recording shows a short passage through the sigmoid colon. One recognizes numerous non-inflamed diverticula. They are partially filled with stool. In some cases, individual deep diverticula can be visualized in their entirety. There are no inflammatory changes visualized. There is no evidence of a tumor.
This is a very common finding with typical localization in the sigmoid colon. Ultrasound examination often returns findings of wall thickening in the sigmoid colon. Colonoscopy, however, is still indicated to exclude malignant disease. Active peristalsis may hamper advancing the endoscope and make orientation difficult. It is especially important, when advancing the endoscope, to very carefully assess visibility, in order not to confuse a diverticulum with the intestinal lumen.