Segmental colitis associated with diverticula: A 7-year follow-up study
ABSTRACT We performed a long-term follow-up study of patients with segmental colitis associated with diverticula, in order to clarify the natural history of this disease.
We identified 15 patients who were diagnosed as having segmental colitis associated with diverticula during 1997. We assessed these patients by means of periodic follow-up visits from 1997 to 2004.
Eight of the 15 patients had no clinical recurrence during follow-up. Five patients had sporadic recurrences that were clinically mild (on average, one in 5 years), which responded to topical therapy and often to self-medication. Only two patients were diagnosed during the follow-up period as having Crohn's disease; notably, these were the only patients who did not have hematochezia as the main symptom at onset.
The course of this disease appears to be substantially benign.
SourceAvailable from: Winfried Häuser
Article: Z Gastroenterol. 2014 Jul;52(7):663-710. doi: 10.1055/s-0034-1366692. Epub 2014 Jul 15. [S2k guidelines diverticular disease/diverticulitis]. [Article in German] Leifeld L, Germer CT, Böhm S, Dumoulin FL, Häuser W, Kreis M, Labenz J, Lembcke B, Post S, Reinshagen M, Ritz JP, Sauerbruch T, Wedel T, von Rahden B, Kruis W.Zeitschrift für Gastroenterologie 07/2014; 52(7):663. DOI:10.1055/s-0034-1366692 · 1.67 Impact Factor
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ABSTRACT: Diverticulitis is a well-established complication of diver-ticulosis. Data regarding the endoscopic appearance of di-verticulitis are limited, as colonoscopy is generally contrain-dicated during the acute attack, due to the increased risk of complications, especially bowel perforation. Endoscopic signs of inflammation in patients with diverticulosis are limited to the segments having the diverticulae, with rectal sparing, and appear in the literature as segmental colitis. We report a case of a middle-aged woman with diverticuli-tis who developed aphthous lesions in the rectum and sig-moid a few days after the initiation of symptoms. Other causes of aphthous lesions of the colonic mucosa (ie. Beh-cets disease, Crohn, ischemia, tuberculosis etc.) were excluded. We suggest that the presence of aphthous lesions should not be included in the setting of segmental colitis, but should be considered as endoscopic signs of diverticu-litis, possibly caused by inflammation and ischemia.