Granulomatous Diverticulitis: Who Would Have Thought!

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Pathology

Background:

• Diverticular disease (DD) encompasses various presentations, including chronic colitis.
• Diverticular disease-associated colitis (DAC) is a distinct entity characterized by inflammation.
• DAC commonly affects the left colon, mimicking Crohn's disease.

Observation:

• A patient presented with a tumor-like mass in the right colon.
• The mass was found to be a granulomatous reaction.
• This presentation is unusual as DAC typically affects the left colon.

Findings:

• The right colon mass was diagnosed as secondary to diverticular disease-associated colitis (DAC).
• This represents the first reported case of DAC involving the right colon with granulomatous inflammation in the English literature.
• The findings highlight the potential for DAC to manifest atypically.

Implications:

• This case expands the known spectrum of DAC presentations.
• It underscores the importance of considering DAC in the differential diagnosis of right colon masses, even with granulomatous features.
• Further research may clarify the pathogenesis and management of atypical DAC cases.