Faculty of Medicine

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    Perforated solitary mid-rectal diverticulum diagnosed with colonoscopy: a case report and literature review
    (Oxford University Press (OUP), 2025-12-24)
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    Avramoski, Vladimir
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    Gjinoska, Klaudia
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    Kostovska, Irena
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    Stoicovski, Emil
    Rectal diverticulum is an exceedingly rare clinical entity, typically occurring as a solitary lesion or, less frequently, as up to three diverticula. Its development is often associated with underlying conditions such as obstructive defecation syndrome, rectal malignancy, pelvic floor weakness, chronic rectal impaction, obesity, or infection-related muscular atrophy. Although uncommon, rectal diverticulitis represents a surgical emergency requiring timely recognition and management. In this case, a female patient presented with rectal bleeding and secondary anemia. During the clinical course, the patient developed pelvic sepsis secondary to rectal diverticulitis. Appropriate surgical intervention, combined with antimicrobial therapy and supportive management, led to a favorable outcome. Rectal diverticulitis is a rare but potentially life-threatening condition. Awareness of this entity and early diagnosis are essential to prevent severe complications such as perforation and pelvic sepsis. This case highlights the importance of considering rectal diverticulum in the differential diagnosis of lower gastrointestinal bleeding and pelvic infections.
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    Right-sided colonic diverticulitis in the young population
    (Shiraz University of Medical Sciences, 2023-12)
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    Although it is a condition of the elderly, diverticular disease (especially in the right colon) is seen in patients under the age of 50. In the past two decades, there have been an increasing number of reports on right-sided colon diverticulitis in the young population. Etiological and epidemiological studies give us partial answers on the occurrence of this condition. The sidedness and the fact that it occurs in younger populations makes this condition actual in terms of early and proper diagnosis thus avoiding unnecessary surgical explorative laparoscopies, laparotomies, appendectomies, etc. Most of the cases with acute right-sided colonic diverticulitis are mild, thus requiring a conservative treatment. However, complicated right-sided colonic diverticulitis is treated with some kind of intervention (percutaneous drainage or surgery). No treatment guidelines are present yet and the approach should be individualized and tailored according to the patient's condition and the severity of the diverticulitis. In case of a clinical deterioration, surgery should be considered regardless open or minimally invasive.