Complications of sigmoid diverticulitis -A case series

Acute colonic diverticulitis is a painful condition of the colon characterised by inflammation of the colonic diverticulum. Majority of these cases involve diverticulum of the sigmoid colon. The recurrence of episodes of diverticulitis in such cases lead to wide spectrum of complication ranging from chronic abdominal pain to perforation and peritonitis which have to be treated according to the presentation of the patient. The case series will deal about the various complications encountered in a group of patients with sigmoid diverticulitis. The objective of our study is to analyse the various complications associated with sigmoid diverticulitis and their management. A case series involving 6 patients diagnosed with sigmoid diverticulitis in our institute (Sri Ramachandra Institute of Higher Education and Research) to analyse their complications and treatment. First case is a sigmoid diverticular abscess mimicking a urachal abscess. Second case is a colo-cutaneous fistula. Third case is a colo-vesical fistula. Fourth case is sigmoid diverticular perforation. Fifth case is sigmoid diverticulitis with sealed off perforation. Sixth case is sigmoid diverticulitis complicated by pericolic abscess formation. A case series involving 6 cases with various presentations of complication of sigmoid diverticulitis has been reported here. Complications of sigmoid diverticulitis as stated by Hinchey classification along with various types of sigmoid fistulas are seen in this case series. Various complications can be expected in sigmoid diverticulitis especially in patients with previous history of disease. The management is based depending on type of complication and whether it takes an acute or chronic manifestation. Proper pre-operative evaluation and appropriate surgical management will lead to cure without much complication.