Endoscopic Diverticular Ridge Myotomy to Treat Acute Colonic Diverticulitis Caused by Impacted Fecalith

A 26-year-old male was referred to our hospital for persistent abdominal pain and fever (38 °C) that had started 4 days before. Physical examination showed tenderness in the right lower abdomen, and white blood cell count was 10.9 × 109 /L. Computed tomography scan demonstrated ascending colonic diverticulitis caused by a calcified fecalith (Figure A; red arrow). The patient was treated with antibiotics for 3 days, but the abdominal pain persisted, and the WBC count continued to increase. Given the computed tomography scan finding of an incarcerated fecalith, we decided to perform endoscopic diverticular ridge myotomy (EDRM) to remove it.