Giant Sigmoid Diverticulum: Imaging Features and Management

About 50% of individuals older than 60 years of age develop diverticulosis predominantly involving the sigmoid, and 10-20% of them will experience complications during their lifetime, such as diverticulitis, hemorrhage, perforation and fistula to the adjacent organs.1,2 However, a giant sigmoid diverticulum (GSD) is a rare complication and may present a diagnostic and therapeutic challenge for those who are unfamiliar with the condition.3-6 The majority of publications about GSD have been isolated case reports in the surgical literature. Clinical Implications Despite the high incidence of diverticular disease among the aging population of the West, GSD are a rather rare complication.2-5 This pathologic process was first described in the French medical literature in 1946 by Bonvin and Bonte.7 Another description appeared 6 years later in an English surgical article.8 A comprehensive review of the world literature was conducted in 2015 by Nigri, et al.6 Their investigation revealed a total of 166 cases of GSD in 138 publications, with the majority being isolated case reports or small case series. Patients with type 1 GSD may be asymptomatic or have only vague abdominal discomfort. [...]the lesion may be detected incidentally during radiological examinations for unrelated abdominal conditions. [...]radiologists, surgeons, and gastroenterologists should be familiar with the imaging features of GSD and its management.