Giant colonic diverticulum, clinical presentation, diagnosis and treatment: Systematic review of 166 cases

Table 1 Symptoms of giant colonic diverticulum in 166 patients (review of the literature) n (%)

Symptoms	Patients (n = 166)
Abdominal pain	115 (69)
Constipation	29 (17)
Diarrehea	19 (11)
Vomiting	20 (12)
Nausea	16 (10)
Abdominal mass	29 (17)
Rectal bleeding/melena	15 (9)
Urinary problems	11 (7)
Weight loss	8 (5)
Asymptomatic	7 (4)
Anorexia	7 (4)
Vaginal bleeding	2 (1)
Meteorism	3 (2)
Dyspepsia	1 (0.6)
Symptoms of bowel obstruction	2 (1)
Difficulty in breathing	1 (0.6)
Tenesmus	1 (0.6)

Each patient may present with one or more symptoms.

Table 2 Signs of giant colonic diverticulum in 166 patients (review of the literature) n (%)

Physicalsigns	Patients (n = 166)
Abdominal mass, non-tender	47 (28)
Abdominal mass, tender	34 (20)
Fever	33 (20)
Abdominal tenderness	24 (14)
Normal	15 (9)
Acute abdomen	10 (6)
Abdominal distension	15 (9)

One or more signs may be present in each patient.

Table 3 Treatment of giant colonic diverticulum in 166 patients (review of the literature) n (%)

Operation	Patients (n = 166)
Resection, primary anastomosis	95 (57.2)
Resection, primary anastomosis and drainage	1 (0.6)
Diverticulectomy	17 (10.2)
Resection, colostomy	19 (11.4)
Conservative treatment	13 (7.8)
Diverticulectomy,colostomy	3 (1.8)
Drainage	4 (2.4)
Not mentioned	4 (2.4)
Laparoscopic colectomy	5 (3)
Excision of the cyst	3 (1.8)
Colectomy, ileostomy	1 (0.6)
computed tomography-guided percutaneous intervention	1 (0.6)

Table 4 Case reports of giant colonic diverticulum in adults, published in the last 5 years

Ref.	Treatment	Type	Complications	Hospital stay
Kam et al[4]	Left colectomy with primary anastomosis and abscess drainage	1,2	No	NR
Kim et al[5]	Laparoscopic right colectomy	3	No	7 d
Filippucci et al[6]	Sigmoid resection with primary anastomosis	NR	No	NR
Mahamid et al[7]	Laparoscopic sigmoidectomy	NR	Nr	NR
Khaikin et al[8]	Hartmann’s resection	2	No	NR
Anderton et al[9]	IV antibiotics (high-risk for laparotomy)	NR	No	3 d
Olakowski et al[10]	Right colectomy	3	No	7 d
Sasi et al[11]	Hartmann’s resection	NR	No	NR
Beddy et al[12]	Hartmann’s resection	2	Hypotension	14 d
Collin et al[13]	Laparoscopic sigmoidectomy	2	No	4 d
Hogan et al[14]	No treatment (asymptomatic patient)	NR	Nr	NR
Chatora et al[15]	Excision of the cyst	1	No	NR
	laparoscopic sigmoidectomy	1	No	NR
Abdelrazeq et al[16]	Sigmoidectomy	NR	No	NR
Guarnieri et al[17]	Left colectomy	NR	No	9 d
Present study	Sigmoid resection with primary anastomosis and ileostomy	2	No	7 d

NR: Not reported.