A Case of Cecal Diverticulitis Complicated by Pseudoaneurysm in the Ileocolic Artery

Acute colonic diverticulitis is a common gastrointestinal illness. It has several complications, such as perforation, abscess, and fistula formation. In addition, pseudoaneurysm caused by diverticulitis has been reported. We report a case of cecal diverticulitis complicated by pseudoaneurysm in the ileocolic artery. A 58-year-old Japanese man was referred to our hospital for abdominal pain. Abdominal examination revealed right lower quadrant pain. Computed tomography (CT) scans showed the presence of diverticula and pericolic fat stranding in the cecum. Following this, he was diagnosed with cecal diverticulitis. Despite antibiotic treatment, his abdominal pain and blood test results worsened. On the third hospital day, a CT scan was performed again, revealing a pseudoaneurysm with hematoma in the ileocolic artery. Interventional radiology (IVR) was conducted to treat the pseudoaneurysm. It was embolized with n-butyl-2-cyanoacrylate (NBCA) and lipiodol. After embolization, he had stable hemoglobin. His abdominal pain and blood test results improved. Pseudoaneurysms have been reported as a rare complication for diverticulitis. When a rupture occurs, it has a high risk of mortality. Early diagnosis and treatment of pseudoaneurysms are essential, and we should consider pseudoaneurysms as a complication of acute colonic diverticulitis.