Symptomatic Uncomplicated and Extensive Colonic Diverticular Disease: A Report of Two Cases and Literature Review

Abstract

Introduction: Diverticular Disease (DD) consists of diverticulosis and diverticulitis. In Diverticulosis of colon diverticulum/diverticuli (Pouches) develop in it. Symptomatic Uncomplicated Diverticular Disease (SUDD) is a syndrome, characterized by local abdominal pain with bowel movement changes but without systemic inflammation. If an acute diverticulitis does not resolve completely, Chronic Diverticulitis can develop. It is associated with localized or distant abscess/phlegmon. DD is an underrecognized disease especially in India, requiring early diagnosis, management and prevention as it impairs Quality of Life of patient.

Case Presentation: We report of two cases of DD, an elderly diabetic and hypertensive male with non-mucoid loose stools 4-5 times per day for 10 days and second elderly diabetic male with diffuse abdominal pain, and discomfort, localized to the right lower quadrant. The first was diagnosed with CT as a case of multiple diverticuli in Sigmoid colon and focal Diverticulitis of descending colon.

Second case: Imaging revealed ileo-caecal and appendiceal thickening with peritoneal nodularity, raising suspicion for malignancy. Colonoscopy demonstrated pan-colonic diverticulosis and a caecal mass-like lesion. Histopathology, and PET-CT were negative for malignancy. A diagnosis of Extensive Colonic Diverticular Disease with Appendicular phlegmon was made. Both cases responded to conservative treatment with antibiotics and anti-inflammatory medicines.

Conclusion: Loose stools should be investigated properly as they could be the very first indication of DD in elderly. On the other-hand extensive colonic DD can mimic malignancy on imaging, when involving ileo-caecal region and appendix. A multidisciplinary, stepwise approach integrating imaging, colonoscopy, and histopathology is critical to accurate diagnosis and optimal patient outcomes.

DOI: https://doi.org/10.24321/2454.325X.202617

How to cite this article:
Vaghela J F, Gupta B, Dogra A. Symptomatic Uncomplicated and Extensive Colonic Diverticular Disease: A Report of Two Cases and Literature Review. Int J Preven Curat Comm Med. 2026;12(3):43-48.