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Granulomatous inflammation in sigmoid diverticulitis: two diseases or one?
S H Burroughs1, D J Bowrey, G J Morris-Stiff
1Department of Pathology, University of Wales College of Medicine, Cardiff, UK.
Histopathology
|November 21, 1998
Summary
Granulomatous inflammation in sigmoid colectomy specimens can mimic Crohn's disease. Clinical follow-up of eight patients confirmed this inflammation is part of diverticulitis, not inflammatory bowel disease.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Pathology
Background:
- Histological findings in sigmoid colectomy specimens can resemble Crohn's disease.
- This raises questions about dual pathology versus localized inflammation within diverticular disease.
Purpose of the Study:
- To differentiate granulomatous inflammation in sigmoid colectomy specimens.
- To determine if it represents Crohn's disease or a manifestation of diverticulitis.
Main Methods:
- Clinical follow-up of eight patients who underwent sigmoid colectomy for complicated diverticular disease.
- Histopathological analysis of surgical specimens for granulomas and other inflammatory markers.
Main Results:
- Eight patients with sigmoid diverticulitis and granulomatous inflammation were identified.
- Granulomas were found in the bowel wall and lymph nodes; no fissuring ulcers typical of Crohn's disease were observed.
- During a median follow-up of 51 months, none developed chronic inflammatory bowel disease.
Conclusions:
- Granulomatous inflammation is likely a spectrum of sigmoid diverticulitis.
- Avoid misdiagnosing this finding as Crohn's disease in patients with diverticular disease.