Unusual extraperitoneal presentations of diverticulitis.

Extraperitoneal presentations of complicated diverticular disease are unusual. The initial clinical presentations of these extraperitoneal manifestations have been described in the perineum, scrotum, buttock, hip, joints, thigh, lower extremities, mediastinum, and neck. These presentations render the diagnosis difficult and may lead to the delay of the proper therapy. The purpose of this report is to call attention to these unusual extraperitoneal presentations of complicated diverticular disease to describe the routes of spread and to present a case in point. Reviewing the literature, we have concluded that these unusual presentations occur more commonly in women and the elderly, that a delayed diagnosis significantly increases the mortality rate, and that the most common site of an extraperitoneal presentation is in the area of the hip.