Intra-abdominal Desmoid-Type Fibromatosis Mimicking Diverticulitis With Abscess: A Case Report

Abstract

Background: Intra-abdominal desmoid-type fibromatosis (DF) rarely necessitates emergency surgery. However, the condition is difficult to diagnose preoperatively and can become life-threatening if left untreated.

Case report: A 46-year-old man complained of fever and right lower quadrant pain. In computed tomography, the mesenteric side of the ascending colon demonstrated air and fluid collections, suggesting diverticulitis with abscess. After 2 weeks of conservative treatment with fasting, the patient started to consume food; nonetheless, fever returned. Colonoscopy and contrast enema detected a fistula extending from the ascending colon to the abscess, with no surrounding lesions. Surgery was then performed because the abscess was refractory. During laparotomy, the scar tissue of the abscess was found to be attached to the lateral wall of the ascending colon. Hence, right colectomy combined with abscess resection was performed. Histopathological findings revealed DF in the mesentery.

Conclusion: Although rare, DF should be included in the preoperative differential diagnosis of intra-abdominal abscesses.

Keywords: Desmoid-type fibromatosis; abscess; desmoid tumor; fistula.