Rectal Diverticulitis with Perforation

Giustra, Peter E.; Root, John A.; Killoran, Paul J.

doi:10.1148/105.1.23

Cited by 11 publications

(6 citation statements)

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“…There are a few case reports of rectal diverticulitis, perforation due to faecal impaction and inverted diverticulum causing rectal prolapse. 12,[16][17][18] Two rare instances of a mucinous adenocarcinoma arising from rectal diverticulum are described in the literature. 19 Accidental perforation of rectal diverticula during colonoscopy or ultrasound guided prostate biopsy has been reported.…”

Section: Discussionmentioning

confidence: 99%

Pulsion diverticula of the rectum: Radiological diagnosis and clinical implications

Ghahremani

Mittal

2021

J Med Imag Rad Onc

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Introduction: The aim of this study was to investigate the appearance of acquired rectal diverticula on barium enema and computed tomography (CT) and to review the pertinent clinical data about this entity. Methods: This series included 3 men and 6 women, who ranged in age from 47 to 82 years (average: 64 years). Air-contrast barium enema in 6 patients with history of anorectal disease or obstructed defecation demonstrated rectal diverticula. In these cases, multiple radiographs of the rectosigmoid region were obtained in upright position while the patient was relaxing or straining without any attempt to evacuate the barium. In 3 cases, the lateral rectal diverticula were incidental finding on CT studies that were performed for various unrelated abdominal complaints. Results: Pulsion type of diverticulum presenting as a wide-neck outpouching was detected on the lateral rectal wall in 5 and on the posterior wall in 4 patients. They measured 2-3 cm in diameter when filled with contrast material or gas, and became even larger when the intraluminal pressure was increased by straining. Conclusion: Pulsion diverticula of the rectum present as a wide-neck outpouching of the lateral or posterior rectal wall in adult patients. This acquired abnormality is usually associated with coexisting anorectal lesions or defecation disorders. The practising radiologists and colorectal surgeons should be aware of this uncommon condition, its appearance on barium enema and other imaging studies, and its clinical implications.

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Section: Discussionmentioning

confidence: 99%

Pulsion diverticula of the rectum: Radiological diagnosis and clinical implications

Ghahremani

Mittal

2021

J Med Imag Rad Onc

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“…However, they may become inflamed with impacted faeces and progress to abscess formation or perforation, rectal prolapse or stricture, rectal‐vesical fistula or faecaloma (Salem and others 2006). Usually, there is no peritoneal contamination as perforation occurs inferior to the peritoneal reflection (Giustra and others 1972). In dogs, most of the rectum is within the peritoneal cavity.…”

Section: Discussionmentioning

confidence: 99%

Acute gaseous peritonitis after rupture of a retroperitoneal rectal diverticulum in a dog

Saulnier-Troff

Busscher

Hamaide

2008

J of Small Animal Practice

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An 11-year-old, entire male coton de tulear was presented on emergency with acute and severe depression, acute abdominal pain and vomiting of 24 hours duration. Historical complaints included right perineal swelling, dyschezia and tenesmus of 18 months duration. Abdominal ultrasonography and radiography suggested a pneumoperitoneum and positive-contrast colonography showed leakage of contrast medium into the caudal abdomen and the presence of a large retroperitoneal pouch. Exploratory laparotomy allowed the visualisation of faecal leakage from the retroperitoneal space into the peritoneal cavity. Using a perineal approach, a large necrotised rectal diverticulum filled with faeces was found over the retroperitoneal structures. A standard herniorrhaphy was then performed. The dog recovered uneventfully and dyschezia did not recur at the nine month follow-up. Rectal diverticulum rupture associated with peritonitis has not been described in the veterinary literature, to the authors' knowledge, and should be considered as a rare differential diagnosis in dogs being presented with gaseous peritonitis.

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“…10 Several complications of rectal diverticulosis are reported, including abscess formation, perforation, and bleeding. 10,12,13 Cases of rectal diverticulitis reported before the introduction of advanced imaging techniques were most commonly diagnosed after formal resection for the clinical suspicion and the inability to rule out rectal cancer. 4,[14][15][16] Giustra et al diagnosed rectal diverticulitis with perforation after barium enema revealed extraperitoneal contrast extravasation in a patient found to have a rectal diverticulum with an associated rectovaginal septal abscess.…”

Section: Discussionmentioning

confidence: 99%

“…4,[14][15][16] Giustra et al diagnosed rectal diverticulitis with perforation after barium enema revealed extraperitoneal contrast extravasation in a patient found to have a rectal diverticulum with an associated rectovaginal septal abscess. 13 Chiu et al reported a case diagnosed after physical examination findings of a tender rectal mass led to an examination under anesthesia. 10 Evacuation of a fecaloma in a rectal diverticulum and drainage of an associated abscess led to complete resolution of the patient's symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Options for surgical management for complicated rectal diverticular disease include transanal or transvaginal abscess drainage, transabdominal diverticulectomy, and formal low anterior resection for the inability to rule out malignancy. 8,10,13,16 Each case should be individually scrutinized, and risks and benefits should be reviewed with each patient to provide the safest and most efficacious treatment for these rare disorders.…”

Section: Discussionmentioning

confidence: 99%

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Recurrent Rectal Diverticulitis

Lundy

Edwards

Parker

et al. 2006

The American Surgeon

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Diverticular involvement of the colon is very common in the United States. Patients present with asymptomatic diverticuli and may have complications of these, spanning the spectrum of uncomplicated diverticulitis to an acute surgical abdominal as a result of feculent peritonitis. We discuss a patient requiring low anterior resection for intractable symptoms resulting from recurrent rectal diverticulitis as well as a review of the limited literature on the subject of diverticular disease of the rectum.

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Rectal Diverticulitis with Perforation

Cited by 11 publications

References 0 publications

Pulsion diverticula of the rectum: Radiological diagnosis and clinical implications

Pulsion diverticula of the rectum: Radiological diagnosis and clinical implications

Acute gaseous peritonitis after rupture of a retroperitoneal rectal diverticulum in a dog

Recurrent Rectal Diverticulitis

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