Segmental Colitis of Cecum Associated With Cecal Diverticulosis: The First Case

Abstract

Segmental colitis associated with diverticulosis (SCAD) is an uncommon but well-established clinicoendoscopic entity( Hepato-Gastroenterology 2012;59:2119—2121.Colorectal Dis 2010; 12:464—470). Endoscopically it shows hyperemia,friability of the mucosa and microulceration of the folds between colonic diverticula( Crescent Fold Disease).It may cause abdominal pain,diarrhea and rectal bleeding. It should be diffrerntiated from acute diverticulitis. It is usually localized to the sigmoid and descending colon.We report the first case of segmental colitis restricted to the cecum associated with cecal diverticulosis.A 63 year old man underwent screening colonoscopy. he had history of vague RLQ pain off and on for one year.There was no history of nausea,vomiting,hematemesis,melena or hematochezia. He had histiry of osteoarthritis of the hips,COPD,essential hypertension and tobacco abuse.He did not drink alcohol;there was no significant family history. CBC and comprehensive metabolic panel was normal.The physical examination was unremarkable. On colonoscopy he was foiund to have uncomplicated diverticulosis of the sigmoid and descending colon. He had mutiple diverticula in the cecum. The triangular fold in the cecum and the Ileo-cecal valve showed masrked hyperemia,friability and micro-ulceration (Crescent Fold Disease).The ostia of cecal diverticula were normal.The biopsy from the cecal fold showed acute inflammation.