Case report of a giant colonic sigmoid diverticulum causing sigmoid volvulus

Highlights • Giant colonic diverticulum is a rare complication of colonic diverticulosis that occurs when a single diverticulum enlarges to over 4 cm in diameter. • The author presents a rare case of a giant colonic diverticulum that presented as a sigmoid volvulus. The management and pathology are discussed.
Introduction Giant colonic diverticulum is a rare complication of colonic diverticulosis that occurs when a single diverticulum enlarges to over 4 cm in diameter. There have been fewer than 200 cases reported worldwide since it was first described in 1946. Presentation of case The author presents a rare case of a giant colonic diverticulum that presented as a sigmoid volvulus. The patient underwent emergency surgery with resection of the diverticulum and reduction of the volvulus. Discussion Due to their propensity to cause complications and mechanical blockage from their large size, all authors recommend surgical resection of giant colonic diverticula. This has been documented to be safely done by diverticulectomy as was performed in this patient, but also by segmental colectomy, laparoscopic diverticulectomy, or laparoscopic colectomy. Conclusion Giant colonic diverticulum is a rare entity that tends to cause many intra-abdominal complications, including volvulus. Surgical resection is recommended once identified.