Small Intestinal Complications of Diverticulitis of the Sigmoid Colon

David Frager, MD; Ellen L. Wolf, MD; Joseph D. Frager, MD; Thomas C. Beneventano, MD
JAMA. 1986;256(23):3258-3261. doi:10.1001/jama.1986.03380230082031.
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THE CLINICAL and radiological manifestations of diverticulitis of the sigmoid colon are well recognized. Mild cases respond to medical therapy, while more severe and complicated cases require surgical intervention in approximately 25% to 33% of instances.1,2 The barium enema examination usually demonstrates the following: (1) paracolic abscess or fistula, (2) spasm of the sigmoid colon, (3) stricturing of the sigmoid, often with complete obstruction, and (4) fistulas to other viscera, particularly the urinary bladder.3 This study describes the less recognized clinical and radiological findings of small intestinal involvement as a complication of diverticulitis of the sigmoid colon.

Materials and Methods  One hundred forty cases of pathologically documented diverticulitis of the sigmoid, identified at Montefiore Medical Center between January 1980 and December 1985, were reviewed retrospectively. Ten (7.1%) of the patients had evidence of small intestinal involvement at surgery. Nine of these ten patients had a contrast enema examination,


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