{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:53:11Z","timestamp":1781643191356,"version":"3.54.5"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T00:00:00Z","timestamp":1773446400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Inverted colonic diverticulum (ICD) is a rare endoscopic finding that often mimics a sessile polyp or submucosal tumor, increasing the risk of misdiagnosis and inappropriate intervention. Accurate identification is crucial to avoid potential complications such as perforation. This case is notable for its unusual location in the cecum and its initial misdiagnosis as a gastrointestinal stromal tumor (GIST).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 66-year-old man with a 10-year history of chronic constipation underwent routine surveillance colonoscopy, which revealed a 30\u201340\u00a0mm sessile lesion in the cecum near the ileocecal valve with a central depression covered by adherent debris\/impacted fecal material and peripheral hyperemia; water-jet irrigation was attempted but failed to adequately clear the adherent material. Biopsies obtained from the peripheral mucosa showed benign mucosal hyperplasia, and contrast-enhanced computed tomography (CT) demonstrated focal cecal wall thickening without definite radiologic evidence of malignancy; however, malignancy could not be confidently excluded given the lesion\u2019s size and indeterminate preoperative assessment. After multidisciplinary team (MDT) discussion and shared decision-making with the patient and family, laparoscopic right hemicolectomy was performed. Gross examination showed a submucosal mass with a narrow-necked cavity connected to the bowel lumen. Histopathology confirmed inverted colonic diverticulum, with no evidence of dysplasia or malignancy. The patient recovered well without complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case highlights the diagnostic challenges of inverted colonic diverticulum, particularly when located in the cecum. Recognition of endoscopic features and cautious interpretation of imaging are essential to prevent unnecessary or harmful procedures. Surgical resection remains a definitive option when malignancy cannot be excluded or endoscopic diagnosis is inconclusive.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-026-04705-9","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T04:54:55Z","timestamp":1773464095000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Inverted colonic diverticulum of the cecum mimicking a submucosal tumor: a case report"],"prefix":"10.1186","volume":"26","author":[{"given":"Ruizao","family":"Zheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2998-458X","authenticated-orcid":false,"given":"Huihong","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,14]]},"reference":[{"issue":"7","key":"4705_CR1","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1155\/2011\/795241","volume":"25","author":"AV Weizman","year":"2011","unstructured":"Weizman AV, Nguyen GC. Diverticular disease: epidemiology and management. Can J Gastroenterol. 2011;25(7):385\u20139.","journal-title":"Can J Gastroenterol"},{"issue":"1","key":"4705_CR2","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1186\/s13256-018-1652-9","volume":"12","author":"B Zhang","year":"2018","unstructured":"Zhang B, Wang J, Li X, Wang Z, Zhang Y, Yang H. Intussusception caused by an inverted colonic diverticulum: a case report. J Med Case Rep. 2018;12(1):114.","journal-title":"J Med Case Rep"},{"issue":"6","key":"4705_CR3","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1007\/s13244-015-0433-x","volume":"6","author":"AR Zeina","year":"2015","unstructured":"Zeina AR, Mahamid A, Nachtigal A, Ashkenazi I, Shapira-Rootman M. Giant colonic diverticulum: radiographic and MDCT characteristics. Insights Imaging. 2015;6(6):659\u201364.","journal-title":"Insights Imaging"},{"issue":"3","key":"4705_CR4","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1111\/1751-2980.12972","volume":"22","author":"N Gulaydin","year":"2021","unstructured":"Gulaydin N, Iliaz R, Ersoz F. Inverted colonic diverticulum: An endoscopic examination and presentation. J Dig Dis. 2021;22(3):152\u20138.","journal-title":"J Dig Dis"},{"issue":"5","key":"4705_CR5","doi-asserted-by":"publisher","first-page":"101711","DOI":"10.1016\/j.clinre.2021.101711","volume":"45","author":"F Cocomazzi","year":"2021","unstructured":"Cocomazzi F, Carparelli S, Cubisino R, Giuliani AP, Bossa F, Biscaglia G, et al. Inverted colonic diverticulum (ICD): report of two cases and literature review of a not that unusual endoscopic challenge. Clin Res Hepatol Gastroenterol. 2021;45(5):101711.","journal-title":"Clin Res Hepatol Gastroenterol"},{"issue":"5","key":"4705_CR6","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1157\/13119880","volume":"31","author":"R S\u00e1enz","year":"2008","unstructured":"S\u00e1enz R, Kinney TP, Santander R, Yazigi R, Navarrete C, Gobelet J, et al. [Inverted colonic diverticula: an uncommon endoscopic finding]. Gastroenterol Hepatol. 2008;31(5):285\u20138.","journal-title":"Gastroenterol Hepatol"},{"issue":"5","key":"4705_CR7","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1111\/j.1463-1318.2009.01864.x","volume":"12","author":"V D\u2019Ovidio","year":"2010","unstructured":"D\u2019Ovidio V, Di Camillo M, Pimpo MT, Meo D, Vernia P, Caprilli R. An unusual complicated polypectomy and inverted colonic diverticula. Colorectal Dis. 2010;12(5):491\u20132.","journal-title":"Colorectal Dis"},{"issue":"12","key":"4705_CR8","first-page":"639","volume":"134","author":"E Holl\u00e4nder","year":"1993","unstructured":"Holl\u00e4nder E, D\u00e1vid G. [Inverted sigmoid diverticulum simulating polyps]. Orv Hetil. 1993;134(12):639\u201340.","journal-title":"Orv Hetil"},{"issue":"5","key":"4705_CR9","doi-asserted-by":"publisher","first-page":"961","DOI":"10.2214\/ajr.156.5.2017960","volume":"156","author":"SN Glick","year":"1991","unstructured":"Glick SN. Inverted colonic diverticulum: air contrast barium enema findings in six cases. AJR Am J Roentgenol. 1991;156(5):961\u20134.","journal-title":"AJR Am J Roentgenol"},{"issue":"13","key":"4705_CR10","doi-asserted-by":"publisher","first-page":"1643","DOI":"10.12998\/wjcc.v7.i13.1643","volume":"7","author":"H Kayano","year":"2019","unstructured":"Kayano H, Ueda Y, Machida T, Hiraiwa S, Zakoji H, Tajiri T, et al. Colon cancer arising from colonic diverticulum: A case report. World J Clin Cases. 2019;7(13):1643\u201351.","journal-title":"World J Clin Cases"},{"key":"4705_CR11","doi-asserted-by":"publisher","first-page":"e96","DOI":"10.14309\/crj.2017.96","volume":"4","author":"A Canakis","year":"2017","unstructured":"Canakis A, Hopkins M, Parian A. Large Pedunculated Polyp Diagnosed as Inverted Colonic Diverticula. ACG Case Rep J. 2017;4:e96.","journal-title":"ACG Case Rep J"},{"issue":"9","key":"4705_CR12","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1016\/j.dld.2018.06.022","volume":"50","author":"V Zimmer","year":"2018","unstructured":"Zimmer V. Forceps de-inversion converting a polyp into a diverticulum. Dig Liver Dis. 2018;50(9):973\u20134.","journal-title":"Dig Liver Dis"},{"issue":"12","key":"4705_CR13","doi-asserted-by":"publisher","first-page":"1511","DOI":"10.1097\/CM9.0000000000001485","volume":"134","author":"J Lee","year":"2021","unstructured":"Lee J, Kim Y. A clinical trial of submucosal saline injection in inverted colonic diverticula. Chin Med J (Engl). 2021;134(12):1511\u20132.","journal-title":"Chin Med J (Engl)"},{"issue":"13","key":"4705_CR14","doi-asserted-by":"publisher","first-page":"A33","DOI":"10.1016\/j.cgh.2015.08.007","volume":"13","author":"R Pinho","year":"2015","unstructured":"Pinho R, Oliveira M, Mascarenhas-Saraiva M. Endoscopic Full-Thickness Resection of an Inverted Colonic Diverticulum With Intraepithelial Neoplasia Using the Ligate-and-Let-Go Technique. Clin Gastroenterol Hepatol. 2015;13(13):A33\u20134.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"5","key":"4705_CR15","first-page":"e59460","volume":"16","author":"M Al-Badawi","year":"2024","unstructured":"Al-Badawi M, Alturkmani OG, Al Turkmani SG, Attar SA, Al-Midani MH. A Case of Inverted Colonic Diverticulum. Cureus. 2024;16(5):e59460.","journal-title":"Cureus"},{"key":"4705_CR16","doi-asserted-by":"publisher","first-page":"111389","DOI":"10.1016\/j.ijscr.2025.111389","volume":"131","author":"S Sholi","year":"2025","unstructured":"Sholi S, Dawood W, Hajhamad MMH. Inverted colonic diverticulum mimicking a polyp: A case report on diagnostic challenges and clinical implications. Int J Surg Case Rep. 2025;131:111389.","journal-title":"Int J Surg Case Rep"},{"key":"4705_CR17","doi-asserted-by":"publisher","unstructured":"Mocanu I, Laranjo A, Carvalho M, Godinho R. Inverted diverticulum of the colon - a cautious diagnosis. Gastroenterol Hepatol. 2018;41(7):455\u20136. https:\/\/doi.org\/10.1016\/j.gastrohep.2018.04.003.","DOI":"10.1016\/j.gastrohep.2018.04.003"},{"issue":"3","key":"4705_CR18","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/S0016-5107(82)73052-4","volume":"28","author":"AN Shah","year":"1982","unstructured":"Shah AN, Mazza BR. The detection of an inverted diverticulum by colonoscopy. Gastrointest Endosc. 1982;28(3):188\u20139.","journal-title":"Gastrointest Endosc"},{"issue":"1","key":"4705_CR19","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1067\/mge.2000.106539","volume":"52","author":"SI Yusuf","year":"2000","unstructured":"Yusuf SI, Grant C. Inverted colonic diverticulum: a rare finding in a common condition? Gastrointest Endosc. 2000;52(1):111\u20135.","journal-title":"Gastrointest Endosc"},{"issue":"2","key":"4705_CR20","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1159\/000329457","volume":"5","author":"T Ito","year":"2011","unstructured":"Ito T, Sato K, Maekawa H, Sakurada M, Orita H, Komatsu Y, et al. Adult intussusception caused by an inverted meckel diverticulum. Case Rep Gastroenterol. 2011;5(2):320\u20134.","journal-title":"Case Rep Gastroenterol"},{"issue":"3","key":"4705_CR21","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1097\/SMJ.0b013e318198697f","volume":"102","author":"MS Cappell","year":"2009","unstructured":"Cappell MS. The water jet deformation sign: a novel provocative colonoscopic maneuver to help diagnose an inverted colonic diverticulum. South Med J. 2009;102(3):295\u20138.","journal-title":"South Med J"},{"issue":"1","key":"4705_CR22","first-page":"51","volume":"115","author":"MM Estevinho","year":"2023","unstructured":"Estevinho MM, Pinho R, Gomes AC, Correia J, Freitas T. Hemostasis of a bleeding inverted colonic diverticulum. Rev Esp Enferm Dig. 2023;115(1):51\u20132.","journal-title":"Rev Esp Enferm Dig"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-026-04705-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-026-04705-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-026-04705-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:04:20Z","timestamp":1781640260000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12876-026-04705-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,14]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4705"],"URL":"https:\/\/doi.org\/10.1186\/s12876-026-04705-9","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,14]]},"assertion":[{"value":"18 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"202"}}