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Case Reports
. 2010 Jan;24(1):61-3.
doi: 10.1155/2010/158275.

Look out before polypectomy in patients with diverticular disease--a case of a large, inverted diverticulum of the colon resembling a pedunculated polyp

Omero Alessandro Paoluzi  1 , Claudio Tosti, Fabio Andrei, Italo Stroppa, Francesco Pallone
Affiliations
Case Reports

Look out before polypectomy in patients with diverticular disease--a case of a large, inverted diverticulum of the colon resembling a pedunculated polyp

Omero Alessandro Paoluzi et al. Can J Gastroenterol. 2010 Jan.

Abstract
in English, French

Diverticular disease of the colon may be responsible for abdominal symptoms requiring colonoscopy, which may reveal the presence of concomitant polyps. A polyp found during colonoscopy in patients with colonic diverticular disease may be removed by endoscopic polypectomy with electrosurgical snare, a procedure associated with an incidence of perforation of less than 0.05%. The risk of such a complication may be higher in the event of an inverted colonic diverticulum, which may be misinterpreted as a polypoid lesion at colonoscopy. To date, fewer than 20 cases of inverted colonic diverticula, diagnosed at colonoscopy or following air contrast barium enema, have been reported in the literature. The present report describes a 68-year-old woman who underwent a screening colonoscopy, which revealed a voluminous pedunculated polyp that was recognized to be an inverted giant colonic diverticulum before endoscopic polypectomy.

La maladie diverticulaire du colon peut être responsable de symptômes abdominaux exigeant une coloscopie, laquelle peut révéler la présence de polypes concomitants. Un polype trouvé pendant la coloscopie chez des patients ayant une maladie diverticulaire du côlon peut être extrait par polypectomie endoscopique au moyen d’une excision électrochirurgicale à l’anse, une intervention s’associant à un risque de perforation inférieur à 0,05 %. Le risque d’une telle complication peut être plus élevé en cas de diverticule colique inversé qui, à la coloscopie, peut être confondu avec une lésion polypoïde. Jusqu’à présent, moins de 20 cas de diverticule colique inversé, diagnostiqués au moment de la coloscopie ou après un lavement baryté de contraste, sont déclarés dans les publications. Le présent rapport décrit le cas d’une femme de 68 ans qui a subi une coloscopie de dépistage, laquelle a révélé un polype pédonculé volumineux diagnostiqué comme un diverticule colique géant inversé avant la polypectomie endoscopique.

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Figures

Figure 1)
Figure 1)
Two views (A and B) of a large, inverted diverticulum of the colon resembling a pedunculated polyp
Figure 2)
Figure 2)
The lesion moved by biopsy forceps. The neck of the diverticulum resembled a long, thin stalk and the head appeared flat
See this image and copyright information in PMC

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