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Case Reports
. 2019 Nov 27:49:57-60.
doi: 10.1016/j.amsu.2019.11.015. eCollection 2020 Jan.

A case of solitary rectal diverticulum presenting with a large retrorectal abscess

Stefanos Gorgoraptis  1 , Sofia Xenaki  1 , Elias Athanasakis  1 , Anna Daskalaki  1 , Konstantinos Lasithiotakis  1 , Evangelia Chrysou  2 , Emmanuel Chrysos  1
Affiliations
Case Reports

A case of solitary rectal diverticulum presenting with a large retrorectal abscess

Stefanos Gorgoraptis et al. Ann Med Surg (Lond). .

Abstract

Colonic diverticular disease is a common condition, affecting 50% of the population aged above 80. In contrast, rectal diverticular disease is a rare condition with very few cases reported, while symptomatic rectal diverticular disease is even rarer. We present a case of a symptomatic large rectal diverticulum presenting with a retrorectal abscess. A 49-year-old Caucasian female was brought to the emergency department complaining of abdominal pain and weakness in the lower limbs. She was found to have obstructive uropathy and unilateral sciatic neuropathy. She rapidly developed acute abdomen and emergency laparotomy revealed a giant purulent rectal diverticulum. The patient underwent exploratory laparotomy and a loop colostomy was made to decompress the colon.

Keywords: Abscess; Complications; Diverticulitis; Rectal diverticulum.

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Conflict of interest statement

The Authors declare that have no Conflict of Interest.

Figures

Fig. 1
Fig. 1
Axial CT image depicting obstructive uropathy due to gas-filled pelvic structure.
Fig. 2A
Fig. 2A
T2-weighted sagittal image: A thick –walled, flask-shaped structure predominately filled with air adjacent to the rectal wall. Arrow shows horizontal low signal intensity line corresponding to the diverticular sinus tract, as confirmed by subsequent CT.
Fig. 2B
Fig. 2B
STIR coronal image shows diffuse, hyperintense sciatic nerve thickening (arrows), accompanied by edematous appearances of piriformis muscles (*), findings consistent with sciatic neuritis, due to compression by the inflamed rectal diverticulum.
Fig. 3
Fig. 3
CT axial image: Retrograde filled rectum with water soluble contrast enema. A predominately gas-fluid cavity is shown in the pelvis adjacent to the right rectal wall, communicating with the rectal lumen, consistent with a giant rectal diverticulum (arrow depicts the neck of the diverticulum, connecting rectum with the diverticular cavity).
Fig. 4
Fig. 4
The diverticulum during operation.
See this image and copyright information in PMC

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