Diverticular disease–associated colitis: progression to severe chronic ulcerative colitis after sigmoid surgery

Abstract

Recent articles have described a segmental colitis involving an area of diverticulosis within the sigmoid colon, but sparing the rest of the bowel. This disease is similar to ulcerative colitis in its clinical presentation and endoscopic and histologic appearance, but by definition does not involve the rectum or proximal colon. Several different terms have been used to describe this syndrome; they include diverticular disease–associated colitis, 1 Makapugay LM Dean PJ. Diverticular disease–associated chronic colitis. Am J Surg Path. 1996; 20: 94-102 Crossref PubMed Scopus (158) Google Scholar chronic segmental colitis associated with diverticula, 2 Peppercorn MA. Drug-responsive chronic segmental colitis association with diverticula: a clinical syndrome in the elderly. Am J Gastroenterol. 1992; 87: 609-612 PubMed Google Scholar segmental colitis, 3 Cawthorn SJ Gibbs NM Marks CG. Segmental colitis: a new complication of diverticular disease. Gut. 1983; 24 ([abstract]): A500 Google Scholar sigmoiditis, 4 Hart J Baert F Hanauer S. Sigmoiditis: a clinical spectrum of pathologic features, including a distinctive form of IBD. Mod Pathol. 1995; 8 ([abstract]): 62-350 Google Scholar and endoscopic crescent fold disease. 5 Gore S Shepherd NA Wilkinson SP. Endoscopic crescent fold disease of the sigmoid colon: the clinical and histological spectrum of a distinctive endoscopic appearance. Int J Colorect Dis. 1992; 7: 76-81 Crossref PubMed Scopus (87) Google Scholar Only five cases have been reported in which there was progression from segmental sigmoid disease to typical chronic ulcerative colitis; the response to specific therapy and subsequent clinical progress were not described.