Colitis cystica profunda: presenting with complete intestinal obstruction and recurrence

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Pathology

Background:

• Colitis cystica profunda (CCP) is a rare, benign condition characterized by cystic and gland-like structures in the colonic wall.
• While typically associated with chronic inflammation or polyps, this case presents without antecedent colonic disease.

Observation:

• A patient presented with intestinal obstruction caused by a polypoid mass in the descending colon.
• Colectomy revealed the mass to be colitis cystica profunda.
• Three additional, separate CCP lesions were identified in the ascending, transverse, and sigmoid colon.

Findings:

• The diagnosis of colitis cystica profunda was confirmed histopathologically.
• The absence of prior or concurrent colonic disease was noted.
• Recurrence of CCP in the remaining colon and rectum occurred within one year post-colectomy.

Implications:

• This case highlights the potential for extensive and multifocal presentation of colitis cystica profunda.
• The recurrence underscores the importance of long-term surveillance after colectomy for CCP, even in the absence of predisposing factors.
• Further research into the etiology and optimal management of multifocal CCP is warranted.