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Volume 7, Issue 5 (Suppl) J Gastrointest Dig Syst, an open access journal
ISSN:2161-069X Gastroenterology 2017
November 13-14, 2017
November 13-14, 2017 | Las Vegas, USA
13th International Conference on
Clinical Gastroenterology, Hepatology and Endoscopy
Pseudotumor coli: An unusual case of large bowel obstruction
Karolina Siniakowicz
Hackensack University Medical Center, USA
Large bowel obstruction secondary to malignancy occurs in 15% of patients diagnosed with colorectal cancer. While evidence of a
lesion on CT may be pathognomonic of malignancy, it frequently has highly overlapping features on CT with diverticulitis. Acute
diverticulitis, although associated with numerous complications, rarely causes large bowel obstruction. However, several case reports
implicate chronic inflammation playing a larger role. In acute diverticulitis, inflammatory cells breach the integrity of the wall to cause
perforation, fistulization and rarely obstruction. Although fistulization is not uncommon, there are few reports describing organ
adherence due to chronic inflammation without CT evidence of a fistula. In chronic diverticulitis, fibrosis of the muscularis could
be a predisposing factor to obstruction, as it causes bowel stenosis. This report describes a 67-year-old female, presenting with large
bowel obstruction, and a sigmoid lesion reported on CT. Initial sigmoidoscopy revealed significant narrowing of the lumen, without
evidence of a mass or inflammation. Patient underwent decompression and surgical resection of the lesion. Pathology revealed a focal
area with acute and chronic diverticulitis and abscess with ovarian tissue and fallopian tube adherent to the serosal surface. This case
suggests the cause of above presentation to be dual: chronic inflammation causing muscularis fibrosis and nearby organ adherence
as well as acute inflammation with abscess formation causing bowel edema and further decrease in luminal diameter. Therefore,
in a patient with chronic constipation and diverticular disease such constellation of events could significantly predispose them to
obstruction and increase in mortality.
Biography
Karolina Siniakowicz has obtained her Medical degree from Touro College of Osteopathic Medicine in New York City. She has extensive research experience, ranging
from topics of diabetes mellitus to neurodegenerative disease, and has co-authored many publications prior to entering the field of Medicine. She is currently pursuing her
Residency in Internal Medicine, and aspires to enter Gastroenterology Fellowship in 2018.
Karolina Siniakowicz, J Gastrointest Dig Syst 2017, 7:5 (Suppl)
DOI: 10.4172/2161-069X-C1-056