start-ver=1.4
cd-journal=joma
no-vol=61
cd-vols=
no-issue=5
article-no=
start-page=299
end-page=303
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2007
dt-pub=200710
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Intramesocolic Diverticular Perforation of the Sigmoid Colon Diagnosed by Detecting Air Collection in Anterior Pararenal Space on Computed Tomography: Report of a Case
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=A 64-year-old woman was admitted to our hospital with lower abdominal pain. Routine laboratory values were unremarkable except for the white blood cell count (15,000/micro litter) and the C-reactive protein (CRP) value (22.5 mg/dl). A Computed tomography (CT) scan revealed air collection in the middle of the anterior pararenal space. One day later, CT revealed air collection in the anterior pararenal space spread to the right side and abscess in the sigmoid mesentery. Because an intramesocolic perforation of the sigmoid colon was suspected, an emergency operation was performed. Abscess formation was recognized in the sigmoid mesentery, and sigmoidectomy including the contaminated mesentery and Hartmann.s procedure were performed. The perforation was 3 cm in diameter, and some diverticula were present in the vicinity of the perforated site. The specimen microscopically revealed perforation at the edge of the diverticulum in association with sudden disruption of the proper muscle layer. Based on pathological findings, intramesocolic diverticular perforation of the sigmoid colon was diagnosed. The present case is a very rare condition. However, it was possible to make a diagnosis preoperatively by detecting air collection in the anterior pararenal space on CT scan. If a sigmoid perforation occurs between the leaves of the mesocolon, air extends into the root of the sigmoid mesocolon and within the anterior pararenal space.
en-copyright=
kn-copyright=

en-aut-name=AshizawaTatsuto
en-aut-sei=Ashizawa
en-aut-mei=Tatsuto
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=

en-aut-name=HamaKoichiro
en-aut-sei=Hama
en-aut-mei=Koichiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=

en-aut-name=TanakaHiroaki
en-aut-sei=Tanaka
en-aut-mei=Hiroaki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=

en-aut-name=AndoMasayuki
en-aut-sei=Ando
en-aut-mei=Masayuki
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=

affil-num=1
en-affil=
kn-affil=Hachioji Medical Center of Tokyo Medical University

affil-num=2
en-affil=
kn-affil=Hachioji Medical Center of Tokyo Medical University

affil-num=3
en-affil=
kn-affil=Tokyo Metropolitan Toshima General Hospital

affil-num=4
en-affil=
kn-affil=Tokyo Metropolitan Toshima General Hospital
en-keyword=colon diverticulosis
kn-keyword=colon diverticulosis
en-keyword=intramesocolic perforation
kn-keyword=intramesocolic perforation
en-keyword=computed tomography
kn-keyword=computed tomography
en-keyword=free air
kn-keyword=free air
END