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Refractory diverticular colitis with progressive ulcerative colitis-like changes extending to the rectum.

Tateki Yamane1, Kan Uchiyama, Takayuki Ishii

  • 1Division of Gastroenterology and Hepatology, Department Of Internal Medicine, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan. Yamane@jikei.ac.jp

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
|August 21, 2009
PubMed
Summary

Diverticular colitis (DC) can mimic ulcerative colitis (UC) and may require surgery when refractory to treatment. This rare case highlights progressive UC-like changes in DC, even in the rectum.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • Diverticular colitis (DC) is an uncommon complication of colonic diverticulosis.
  • It can present with symptoms overlapping those of inflammatory bowel disease, such as ulcerative colitis (UC).

Observation:

  • A 68-year-old man presented with diarrhea and bloody stools.
  • Colonoscopy revealed sigmoid diverticula with localized inflammation.
  • Over 15 months, mucosal changes progressed to an erosive, ulcerative colitis-like appearance extending to the rectum.

Findings:

  • Diagnosis of diverticular colitis with progressive, UC-like changes.
  • The condition was refractory to medical management.
  • Surgical intervention was ultimately required.

Implications:

  • This case underscores the potential for DC to exhibit severe, progressive inflammation mimicking UC.
  • Refractory DC may necessitate surgical treatment.
  • The rarity of DC, particularly with extensive rectal involvement, is noted, with no prior reports in Japan.