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Published on: July 12, 2018
Diverticular disease-associated segmental colitis
Laura W Lamps1, Whitfield L Knapple
1Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72212, USA. LampsLauraW@uams.edu
Summary
Diverticular disease-associated segmental colitis mimics inflammatory bowel disease but is confined to diverticula-containing colon segments. Early diagnosis requires detailed endoscopic descriptions to aid pathologists in distinguishing it from ulcerative colitis or Crohn's colitis.
Area of Science:
- Gastroenterology
- Pathology
Background:
- Diverticular disease-associated segmental colitis is a distinct chronic colitis variant.
- It affects left colon segments with diverticula and mimics idiopathic inflammatory bowel disease.
- Histologically, it can be indistinguishable from ulcerative colitis or Crohn's colitis.
Purpose of the Study:
- To highlight the unique characteristics of diverticular disease-associated segmental colitis.
- To emphasize the importance of endoscopic findings in differentiating this condition from other colitis types.
- To guide appropriate diagnostic and therapeutic strategies.
Main Methods:
- Clinical presentation review (hematochezia, abdominal pain).
- Colonoscopic evaluation of inflammatory changes.
- Histologic analysis of biopsy samples.
- Correlation of endoscopic and histologic findings.
Main Results:
- Inflammatory changes are limited to diverticula-containing segments with rectal sparing.
- The condition may be an immunologically mediated process, not solely diverticulitis.
- Some patients respond to diverticulitis treatment, while others require immunosuppression or surgery.
- A subset may progress to classic ulcerative colitis.
Conclusions:
- Diverticular disease-associated segmental colitis requires careful endoscopic and histologic evaluation.
- Accurate macroscopic description by endoscopists is crucial for accurate pathologic interpretation.
- Distinguishing this entity from ulcerative colitis and Crohn's colitis is essential for patient management.
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