Question

A 61-year-old man presents to the clinic for an annual wellness exam. He denies any specific concerns except for some constipation for the past week. His past medical history is significant for hypertension that is controlled with lisinopril. He denies fever, weight changes, melena, hematochezia, abdominal pain, or stool changes. He subsequently undergoes a routine colonoscopy which demonstrates small outpouchings within the sigmoid colon. What is the diagnosis?

Answer 1

The diagnosis for the patient with outpouchings in the sigmoid colon is diverticulosis, which can be asymptomatic and is not indicative of colorectal cancer in the absence of severe symptoms.

Step-by-step explanation:

The diagnosis for the 61-year-old man with small outpouchings within the sigmoid colon, as seen during a routine colonoscopy, is diverticulosis. This condition is characterized by the formation of pouches on the colon wall, which can occur with aging. Constipation can be a symptom of diverticulosis, but the condition is often asymptomatic.

The patient's lack of symptoms such as fever, weight changes, melena, hematochezia, abdominal pain, or changes in stools—typical signs of more severe conditions like colorectal cancer—favors a diagnosis of diverticulosis. Colorectal cancer is usually signaled by more severe symptoms and often begins as benign mucosal growths known as polyps. To prevent colorectal cancer, routine screenings like colonoscopies are recommended for individuals over the age of 50 to identify and remove precancerous polyps.