Hormati A*1,Ghadir MR1,Sarkeshikian SS1,Iranikhah A2 and Yousefi MH3
Received: March 15, 2018; Published: May 21, 2018
Corresponding author: Ahmad Hormati, Gastroenterology & Hepatology Research Center , Shahid Beheshti Hospital, Qom School of Med, Qom University of Medical Sciences, Iran
A 61 years old woman was referred to gastroenterology clinic for evaluation of abdominal pain. She complained from changeless pain in RUQ persisting for three months. She didn’t have any other symptoms, anemia, and weight loss.
In physical examination, patient didn’t have any abnormal sign. Laboratory test were normal. Colonoscopy of the patient showed a 30×15mm sub mucosal lesion in the Ascending colon near to hepatic flexure. In gross view the sub mucosal lesion was similar to normal mucosa with large circumferential pedicle that changed its appearance according to low and high insufflations degree (Figure 1 & 2).
CT scan revealed a well-margined intraluminal mass in proximal portion of the Ascending colon measured 31×16mm containing some small gas bubbles with suggestion of a large inverted colonic diverticulum (ICD) (Figure 3-5).
True colonic polyps and Gastrointestinal Stromal Tumors (GISTs) are main differential diagnosis for ICD. This differentiation is very important during colonoscopy. Polypectomy is contraindicated in ICD because of the risk of colonic perforation .
ICD occurred in 0.7% of population. Some maneuvers such as air insufflations [2,3], attempting to revert of the lesion with forceps , or water jet deformation sign  help colonoscopists in diagnosis of ICD.
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