Sigmoid colon diverticulosis with stenosis: case report and review of the Japanese literature

We treated a 68-year-old woman for stenosis arising from colonic diverticulosis. Two years previously, she had developed diverticulitis of the sigmoid colon, received conservative treatment, and was being carefully watched at another hospital. She began to experience irregular bowel movements and thus visited our hospital. Detailed examination showed circumferential stenosis of the colon, and passage of the endoscope could not be achieved. We suspected stenosis due to diverticulosis of the sigmoid colon. However, because FDG-PET/CT showed pathologic uptake and because of the change in the patient’s bowel habits, malignancy could not be ruled out, so surgery was performed. We observed circumferential thickening of the wall of the sigmoid colon and severe adhesion to the surrounding organs. Again, malignancy could not be ruled out, so sigmoidectomy with lymph node dissection was performed. Histopathologic examination revealed multiple diverticula, infl ammatory cell infi ltration into the intestinal wall, and thickening of the intestinal wall, but no malignant cells. Stenosis resulting from diverticulosis of the sigmoid colon was thus diagnosed. The postoperative clinical course was satisfactory, and the patient was discharged on postoperative day 11. Colon diverticulosis is a common condition, but instances of stenosis are rare, and the symptoms can be diffi cult to differentiate from those of colon cancer. We report this case in the hope that it will be a useful addition to the reference