Giant colonic diverticula - Review of diagnostic and therapeutic options

Background: A rare complication of diverticulosis of the colon is giant colonic diverticula (GCD). The condition was first described in English literature in 1953 [ 1, 2]. Methods: A Medline search was undertaken for English, French and German language articles on 'giant colonic diverticula'. Results: A total of 135 patients were identified, presenting with a total of 155 GCD [1 - 98]. With a complication rate of 28% and an operative mortality of 5%, GCD seems to have a high clinical significance. Radiological examination of choice seems to be plain abdominal X-ray and CT examination, barium enema carries the risk of perforation of the diverticulum, and should not be performed. Conclusions: There are different therapeutic options, in our opinion diverticulectomy alone is not the treatment of choice. Because of the possibility of recurrence and oncological reasons, colectomy seems to be the best treatment. The creation of a protecting colostomy depends on other operative findings. Copyright (C) 2004 S. Karger AG, Basel.