Hospital Cases

Hospital Cases  > Surgical  > Diverticulum (Rare)
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Bowel Diverticlum

Gus presented with constipation after eating a lamb roast bone a few days earlier. He was straining quite a lot but was not able to pass anything. There were firm faeces palpable in his abdomen and a rectal exam revealed a “spongy” feel to the right side of his pelvic inlet (like a cystic structure). This was at first thought to be a prostatic cyst, but he had been desexed at a young age.

Xrays showed pieces of bone in the colon and lots of faeces backed up behind them. There was also a marked narrowing of the colon as it entered the pelvic cavity. A faintly outline oval shaped mass could be seen in the pelvic region next to where the colon was constricted. This matched up with what we could feel on rectal examination.

We gave him a microlax enema and some liquid paraffin by mouth, but nothing passed. A high soapy enema under sedation failed to clear the blockage, so we opted for exploratory surgery.

Gus was placed on IV fluids and anaesthetised with Alfaxan IV and then 2% Isoflurane gas.

Upon opening the abdomen, we found a large sausage shaped mass in the pelvic canal which felt like a cystic structure under tight tension. We were able to remove it quite easily by just running our fingers around it and freeing it of some attachments. It did not appear to have a large blood supply or be connected to anything else.

The bones and hard faeces were massaged into the lower colon where an assistant was able to remove them with a finger.

The abdominal wounds were closed as per normal and Gus was given post op pain relief and antibiotics. He made a great recovery and was passing faeces then next morning.

On incising the mass, it was filled with a greenish smelly sludge. After inverting the mass and rinsing it under the tap, the lining looked just like the lining of the large colon (much like tripe looks like at the butchers).

It was suspected to have originated from the bowel wall some time ago as a small “out pocket” of the bowel wall (a diverticulum) and possibly had filled up like a water balloon with faecal material before it eventually closed off the connection to the bowel, and became an isolated mass.

At 10 days post op, Gus came in for his stitches to be removed and he could not wait to get his share of treats that were on offer.

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