{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:10:07Z","timestamp":1756379407087,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,12,29]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Giant colonic diverticulum is an uncommon presentation of colonic diverticular disease. It is characterised by the presence of a diverticulum exceeding 4\u2009cm in size, with approximately 90% of the cases involving the sigmoid colon. Typically, diagnosis relies on CT of the abdomen and pelvis (CTAP). The preferred treatment approach is sigmoid resection with a primary colonic anastomosis. However, in complicated or emergency cases, proctosigmoidectomy with end colostomy (Hartmann\u2019s procedure) is often considered the safest surgical option.<\/jats:p>\n               <jats:p>We present an atypical case of a symptomatic patient with a giant sigmoid diverticulum that had increased in size and symptoms over several years. Initial diagnosis by CTAP revealed an incidental 6\u2009cm sigmoid diverticulum. Over approximately 6 years, the diverticulum enlarged substantially, reaching 20\u2009cm in size. This caused compression of the stomach and splinting of the left hemidiaphragm, resulting in nutritional failure. He was admitted with a plan to optimise for curative surgery; however complications such as nutritional failure and frailty developed, leading to a decision for palliative care.<\/jats:p>","DOI":"10.1136\/bcr-2023-258689","type":"journal-article","created":{"date-parts":[[2025,1,19]],"date-time":"2025-01-19T20:50:15Z","timestamp":1737319815000},"page":"e258689","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Giant sigmoid diverticulum"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7395-0752","authenticated-orcid":false,"given":"Elaine","family":"Ong Ming San","sequence":"first","affiliation":[{"name":"Gastroenterology, Pinderfields General Hospital, Wakefield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mafas","family":"Ali","sequence":"additional","affiliation":[{"name":"Gastroenterology, Pinderfields General Hospital, Wakefield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Bramwell","family":"Sprakes","sequence":"additional","affiliation":[{"name":"Gastroenterology, Pinderfields General Hospital, Wakefield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas Ewin","family":"Burr","sequence":"additional","affiliation":[{"name":"Gastroenterology, Pinderfields General Hospital, Wakefield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,19]]},"reference":[{"key":"2025082803400584000_18.1.e258689.1","first-page":"83","article-title":"Diverticular Disease: A Review on Pathophysiology and Recent Evidence","volume":"89","author":"Piscopo","year":"2020","journal-title":"Ulster Med J"},{"key":"2025082803400584000_18.1.e258689.2","doi-asserted-by":"publisher","DOI":"10.1159\/000074833"},{"key":"2025082803400584000_18.1.e258689.3","doi-asserted-by":"crossref","first-page":"360","DOI":"10.3748\/wjg.v21.i1.360","article-title":"Giant colonic diverticulum: clinical presentation, diagnosis and treatment: systematic review of 166 cases","volume":"21","author":"Nigri","year":"2015","journal-title":"World J Gastroenterol"},{"key":"2025082803400584000_18.1.e258689.4","unstructured":"Nallapeta NS , Patel K , Farooq U . Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK430771\/"},{"key":"2025082803400584000_18.1.e258689.5","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjy009","article-title":"Giant colonic diverticulum-a rare cause of acute abdomen","volume":"2018","author":"Syllaios","year":"2018","journal-title":"J Surg Case Rep"},{"key":"2025082803400584000_18.1.e258689.6","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1159\/000200014","article-title":"Giant Sigmoid Diverticulum: A Rare Presentation of a Common Pathology","volume":"3","author":"Guarnieri","year":"2009","journal-title":"Case Rep Gastroenterol"},{"key":"2025082803400584000_18.1.e258689.7","doi-asserted-by":"publisher","DOI":"10.1007\/BF02556799"},{"key":"2025082803400584000_18.1.e258689.8","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.ijscr.2016.05.029","article-title":"A gas-filled abdominal cyst in an elderly woman: A giant colonic diverticulum case report","volume":"24","author":"Del Pozo","year":"2016","journal-title":"Int J Surg Case Rep"},{"key":"2025082803400584000_18.1.e258689.9","doi-asserted-by":"publisher","DOI":"10.1007\/BF02239441"},{"key":"2025082803400584000_18.1.e258689.10","doi-asserted-by":"crossref","unstructured":"Ghahremani GG . Giant Sigmoid Diverticulum: Imaging Features and Management. AR 2023;17\u201321. doi:10.37549\/AR2864","DOI":"10.37549\/AR2864"},{"key":"2025082803400584000_18.1.e258689.11","doi-asserted-by":"crossref","first-page":"7075","DOI":"10.1186\/1752-1947-3-7075","article-title":"Laparoscopic-assisted resection of a giant colonic diverticulum: a case report","volume":"3","author":"Collin","year":"2009","journal-title":"J Med Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-258689","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:40:18Z","timestamp":1756377618000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-258689"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,19]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2023-258689"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-258689","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}