Hi, I will try to provide a brief history/background. I am 40, was diagnosed with Diverticultis at 28 (young I know). My disease is apparently advance/severe i.e many many tics mainly in the sigmoid but a good handful in the decsending colon.
Dec, 2008, CT with triple contrast, shows Bowel wall thickening with evidence of inflammatory changes in the sigmoid mesocolon. Evidence of mild fatty haziness, and multiple enlarged lymph nodes in the mesocolon. No evidence of abscess formation at this time. Only recommendation from the Radiologist back to GI Spec was for interval endoluminal evaluation. CT 1 year prior was very similar but with no finding of enlarged lymph nodes.
July 2nd, 2009, CTC along with 2d imaging to help with 3d findings. Note, prep was deemed to be moderatley well prepared and distended. Same liver lesions in segment 4b detected, no change in either. Remainder of imaged solid organs are within normal on this none contrast study. Left Inguinal hernia and Hiatal Hernia found. I knew about the Inguinal hernia...the other was new to me. Sever diverticulosis in the sigmoid colon with marked mural thickening. There is hyperemia of the sigmoid mesocolon with adjacent adenopathy measuring between 7-8mms in short axis. No other focol colonic leasions is seen.
The thickening, luminal narrowing and even the hyperemia he said were in keeping with on going diverticulitis.
The presence of adenopathy was somewhat concerning to the Radiologist. The surgeon (former Surgeon in Chief, specializing in Colorectal disease said he was a bit irrtated by the way the report was worded. I didn't speak directly to him but this is what his clinical secretary said to me. He said that I needed to come back early October to repeat the VC and I believe do a CT guided needle biopsy. hts. Doctor said not to panic and that if he thought it was really concerning he would have reacted much more urgently. Please let me know your thoughts.
The CT scans first picked up the lymph nodes in Dec 2008. These were still present in July 2009, measuring about 7 to 8 mm.
This makes it less likely that these lymph nodes are related to cancer or an infective process. If this were the case, the nodes would have considerably enlarged during this period.
Please make sure that surveillence over these nodes is continued as advised.
Hiatal hernia is common in western populations, and mostly not of much clinical significance.
All the best, and God Bless!
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