Korean J Pediatr Gastroenterol Nutr.  2010 Sep;13(2):193-198. 10.5223/kjpgn.2010.13.2.193.

A Case of Ascending Colon Diverticulitis with Perforation in a Child

• Baek JW
• Shin JY
• Lee JH
• Jung SY
• Jung AY
• Kim JW
• Lee KH

• KMID: 1459435
• DOI: http://doi.org/10.5223/kjpgn.2010.13.2.193

Abstract

A diverticulum is a blind pouch communicating with the gut. The term "diverticulitis" indicates inflammation of a diverticulum or diverticula, which is commonly accompanied by gross or microscopic perforation. Acute diverticuitis is a rare disorder in early childhood. Itis difficult to diagnose acute right colon diverticulitis from common causes of RLQ pain. We report a case of acute diverticulitis in the right colon in a 6-year-old girl. She complained of typical RLQ pain mimicking acute appendicitis,but was diagnosed with acute diverticulitis by CT scanning. Conservative treatment failed because of peritonitis due to perforation of an inflamed diverticulum. After the diverticulcetomy, the symptoms resolved.

Keyword

Diverticulitis; RLQ pain; Child

MeSH Terms

Child
Colon
Colon, Ascending
Diverticulitis
Diverticulum
Humans
Inflammation
Peritonitis

Figure

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  Fig. 1 Contrast-enhanced CT shows an outpouching structure (1.8×1.5 cm, arrow) arising from the anterior aspect of the ascending colon with a thick wall and an internal hyper-attenuating fecalith. (A) coronal view, (B) axial view.

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  Fig. 2 Follow-up ultrasound shows aggravated fat infiltration and wall thickening adjacent to the diverticulum.

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  Fig. 3 Intraoperative view of the ascending colon diverticulitis (A: ascending colon, I: terminal ileum, D: diverticulum).

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  Fig. 4 Light microscopic finding shows a diverticulum, including the muscle layer (short arrow). The wall architecture of the submucosa and mucosal integrity are distorted by aggregated lymphocytes and neutrophils (long arrow) (H&E, original magnification ×12.5).

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