Presentation
The patient presented with crampy left lower quadrant pain and intermittent sharp bouts of pain.
Patient Data
There is colonic diverticulosis with acute diverticulitis at the descending-sigmoid colonic junction. Incidentally detected is rectal diverticulosis without diverticulitis.
Case Discussion
Rectal diverticula are outpouchings of the rectal mucosa, often seen in conjunction with colonic diverticulosis. While colonic diverticula are common, rectal diverticula are exceedingly rare with recent incidence rates reported at 0.1% 1.
Though the etiology of rectal diverticula is usually unknown, it can sometimes occur due to congenital abnormalities involving the muscles supporting the rectum. Weakness in the circular muscles around the rectum can predispose patients to diverticula 2.
Rectal diverticula can result in acute diverticulitis, perforation, stool impaction, and malignancy. Symptomatic patients can present with abdominal pain, rectal bleeding, and changes in bowel habits 1. However, rectal diverticula found on imaging of asymptomatic patients require no further treatment. Surgical intervention is usually reserved for patients with complications such as prolapse and abscess drainage.
In our patient, rectal diverticulosis is an incidental and interesting but uncommon finding.
This case was provided by and edited by Ashwin Hampole, M.D.
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