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British Journal of Radiology (2007) 80, e201-e204
© 2007 British Institute of Radiology
doi: 10.1259/bjr/23274345
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Complicated giant diverticulum of the transverse colon accompanied by right inguinal hernia of the greater omentum

S E Yoon, MD 1 Y-H Lee, MD 1 K-H Yoon, MD 1 E-A Kim, MD 1 S S Choi, MD 1 S K Juhng, MD 1 K J Yun, MD 2 and W C Park, MD 3

Departments of 1 Radiology, 2 Pathology and 3 Surgery, Wonkwang University School of Medicine, 344-2 Sinyong-dong, Iksan, Jeonbuk 570-711, Korea


Figure 1
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  		Figure 1. Abdominal radiograph shows increased opacity in the right inguinal area(open arrows) and a downward displacement of the transverse colon (arrows) with a faeces-filled giant diverticulum (arrowheads) in the mid-portion of the pelvic cavity.

 

Figure 2
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  		Figure 2. (a) Contrast-enhanced axial CT scan depicts a bulky greater omentum occupying the right anterior pelvic cavity (asterisk). (b) CT shows a contrast enhancement of the wall of the giant colonic diverticulum (GCD; arrowhead). Note the communication between the GCD and the transverse colonic lumen. Also, haemorrhagic strands are seen adjacent to the GCD (arrow).

 

Figure 3
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  		Figure 3. Oblique coronal multiplanar reformatted CT scan demonstrates a downward displacement of the transverse colon(thin arrows) with giant colonic diverticulum (thick arrows) and the stretched, engorged middle colic vessel (GCD; arrowhead) in the transverse mesocolon. Note a bulky greater omentum (asterisks) lying just above the right inguinal canal (open arrowhead), lateral to the inferior epigastric vessel.

 

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  		Figure 4. (a) The resected specimen shows a 6x4 cm giant diverticulum on the mesenteric side of the transverse colon. Note the iatrogenic perforation of the giant colonic diverticulum (GCD), which occurred during the laparoscopic surgery. (b) Microscopic examination (x100, haematoxylin and eosin stain) reveals transmural infiltration of inflammatory cells through the true GCD wall, which contains all four colonic layers.

 




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