A 74-year-old woman has a 10-year history of intermittent lower abdominal pain. The pain has been colicky in nature and is associated with a feeling of distension in the left iliac fossa. It is generally relieved by-passing flatus or faeces. She tends to be constipated and passes small pieces of faeces. On examination, vague impression of a mass was felt in the left iliac fossa with no guarding or rebound tenderness and the bowel sounds were normal. She had a barium enema performed. An intestinal biopsy was also performed. Colonoscopy ruled any colonic neoplasm. Which of the following procedures can be used in the above condition: –
Correct Answer: All of the above
Description: This is a case of colonic diveiculosis. Barium-filled out-pouching's are seen in both single and double contrast study, there are no signs of colonic masses or luminal narrowing and no abnormal mucosal thickening could be seen. HPE image shows inflamed diveiculum with the diveicular wall made up only of mucosa. They are very common in the elderly Western population probably due to a deficiency in dietary fibre. Symptomatic diveicular disease has many of the features of irritable bowel syndrome. Inflammation in a diveiculum is termed diveiculitis. In severe cases, perforation, paracolic abscess formation or septicaemia may develop. Other potential complications include bowel obstruction. Formation of a fistula into rectum or vagina, and haemorrhage. Procedures approved are: - A. Hamann's procedure B. Washout with proximal diversion C. Percutaneous drainage followed by colonic resection
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