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Case report
Complicated diverticulitis mimicking colonic carcinoma: combined approach with endoscopy and budesonide
  1. Antonio Tursi1,
  2. Angela Marinelli2,
  3. Francesca Laera3 and
  4. Antonio Penna4
  1. 1 Territorial Gastroenterology Service, Azienda Sanitaria Locale Barletta Andria Trani, Andria, Barletta-Andria-Trani, Italy
  2. 2 Division of Gastroenterology, IRCCS “De Bellis” Gastroenterology Hospital, Castellana Grotte, Bari, Puglia, Italy
  3. 3 Engineering Department, Politecnico di Bari Prima Facolta di Ingegneria, Bari, Puglia, Italy
  4. 4 Division of Gastroenterology, “S. Paolo” Hospital, Bari, Puglia, Italy
  1. Correspondence to Professor Antonio Tursi; antotursi{at}tiscali.it

Abstract

Complicated diverticulitis is an uncommon endoscopic finding. We report an unusual case of complicated diverticulitis in a 53-year-old man suffering from chronic constipation, abdominal pain and a recent episode of subocclusion. He underwent to colonoscopy that showed left-sided diverticulosis and a 3 cm irregular mass in the sigmoid. During biopsy sampling due to the suspect of colonic carcinoma, pus and bleeding came out from the lesion. After lavage, a large diverticulum with visible vessel at the bottom was found, which was clipped with stopping bleeding. After a short course of in-hospital treatment, at discharging the patient was treated with budesonide MMX9 mg/day for 8 weeks. At that time, colonoscopy did not show sign of diverticular inflammation, and inflammatory indexes were normal. This case demonstrates that the use of a topical steroid, combined with an endoscopic approach, may easily resolve an unusual endoscopic complication in patients suffering from complicated diverticular disease.

  • endoscopy
  • drugs: gastrointestinal system
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Footnotes

  • Contributors Conception and design, acquisition of data or analysis and interpretation of data: AT, AM, FL and AP. Drafting the article or revising it critically for important intellectual content: AT and AP. Final approval of the version published: AT, AM, FL and AP. Agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved: AT, AM, FL and AP.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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