Question
A 76-year-old woman presented with on and off left lower abdominal pain for 1 year. There were previous episodes of acute exacerbation with associated PR bleeding and fever which were treated
with antibiotics.
Physical examination showed no abdominal or pelvic mass.A double contrast barium enema was performed to exclude colonic pathology.What can be the most possible diagnosis?
A. Colonic Carcinoma
B. Colonic Diverticulosis
C. Ulcerative Colitis
D. Crohn’s Disease
Show Answer
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Correct Answer » B
Explanation
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Ans:B. Colonic Diverticulosis.
Image shows:
- Double contrast barium enema demonstrating multiple colonic diverticuli appearing as small outpouchings (arrows) from the colonic wall.
COLONIC DIVERTICULOSIS
- Colonic diverticulosis is defined as mucosal and muscularis mucosae herniation through defects in the muscularis propria. This is thought to be mainly due to increased intraluminal pressure, possibly as a result of a low fibre diet.
- Colonic diverticulosis most commonly affects elderly patients.
- Left-sided colon is predominantly involved in Caucasians and rightsided in Asians.
- In patients with acute diverticulitis, colonoscopy or barium enema is contra-indicated in view of risk of perforation. In this instance, CT scan helps to support the diagnosis and helps to detect any complication of acute diverticulitis.
- Colonic diverticulosis should be considered in elderly patients with recurrent lower abdominal pain.
- Multiple smooth outpouchings from colonic wall predominantly affecting left-sided colon are the radiological findings.
- CT colonoscopy of another patient shows a diverticulum in the right ascending colon demonstrating a typical appearance of air containing outpouching (arrow) from the colonic wall.
