• Mio Nihei, Teppei Kamada, Takashi Aida, Daisuke Yamagishi, Junji Takahashi, Keigo Nakashima, Eisaku Ito, Norihiko Suzuki, Taigo Hata, Masashi Yoshida, Hironori Ohdaira, and Yutaka Suzuki.
• Department of Surgery, International University of Health and Welfare Hospital, Iguchi, Nasushiobara, Tochigi, Japan.
• Medicine (Baltimore). 2024 Sep 27; 103 (39): e39770e39770.

RationaleComplicated colorectal diverticulitis could be fatal, and an abscess caused by this complication is usually formed at the pericolic, mesenteric, or pelvic abscess. Therefore, we report a rare case of sigmoid colon diverticulitis that developed a large inguinal abscess.Patient ConcernsA woman in her 70s was admitted to our hospital with a chief complaint of left inguinal swelling and tenderness 1 week before admission. Physical examination showed swelling, induration, and tenderness in the left inguinal region. Blood tests revealed elevated inflammatory reaction with C-reactive protein of 11.85 mg/dL and white blood cells of 10,300/μL. Contrast-enhanced computed tomography showed multiple colorectal diverticula in the sigmoid colon, edematous wall thickening with surrounding fatty tissue opacity, and abscess formation with gas in the left inguinal region extending from the left retroperitoneum.DiagnosesThe diagnosis was sigmoid colon diverticulitis with large abscess formation in the left inguinal region.InterventionsImmediate percutaneous drainage of the left inguinal region was performed, as no sign of panperitonitis was observed. Intravenous piperacillin-tazobactam of 4.5 g was administered every 6 hours for 14 days.OutcomesThe inflammatory response improved, with C-reactive protein of 1.11 mg/dL and white blood cell of 5600/μL. Computed tomography of the abdomen confirmed the disappearance of the abscess in the left inguinal region, and complete epithelialization of the wound was achieved 60 days after the drainage. The patient is under observation without recurrence of diverticulitis.LessonsWe report a rare case of sigmoid colon diverticulitis that developed a large inguinal abscess, which was immediately improved by percutaneous drainage and appropriate antibiotics administration.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

25 keywords...

hide…