Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 May 8;15(5):e38724.
doi: 10.7759/cureus.38724. eCollection 2023 May.

Segmental Colitis Associated With Diverticulosis

Om V Sakhalkar  1 , Arnav Goyal  1 , Abdul Rahman Abualruz  1
Affiliations
Case Reports

Segmental Colitis Associated With Diverticulosis

Om V Sakhalkar et al. Cureus. .

Abstract

Segmental colitis associated with diverticulosis (SCAD) is a rare entity characterized by segmental circumferential colonic wall thickening involving the sigmoid and/or left colon in the presence of colonic diverticulosis. We present the case of a 57-year-old female with a past medical history of colonic diverticulosis who presented with chronic intermittent abdominal pain, non-bloody diarrhea, and hematochezia. Imaging revealed long-segment circumferential colonic wall thickening involving the sigmoid and distal descending colon with engorged vasa recta without significant inflammation around the colon or diverticula, consistent with SCAD. Colonoscopy showed diffuse mucosal edema and hyperemia of the descending and sigmoid colon with easy friability and erosions primarily affecting the inter-diverticular colonic mucosa. Pathology showed changes of chronic colitis including inflammation in the lamina propria, crypt distortion, and granuloma formation. Treatment with antibiotics and mesalamine was initiated with improvement in symptoms. This case highlights the importance of considering segmental colitis associated with diverticulosis in patients with chronic lower abdominal pain and diarrhea in the setting of colonic diverticulosis, and the need for a thorough workup including imaging, colonoscopy, and histopathology to differentiate it from other types of colitis.

Keywords: chronic colitis; diverticulosis complications; segmental colitis; sigmoid diverticulitis; sigmoid diverticulosis.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Abdominal CT at the time of patient’s presentation and after management
(A) The axial CT image shows segmental sigmoid colon wall thickening (yellow asterisk), mild pericolonic inflammation (yellow arrowheads) sparing colonic diverticula (white arrowheads), and engorged vasa recta (blue arrowheads). (B) The axial contrast-enhanced CT image obtained after management shows resolution of sigmoid colon wall thickening and surrounding inflammation.
Figure 2
Figure 2. Colonoscopy demonstrating mucosal edema and hyperemia of the sigmoid colon with easy friability and erosions (white arrowheads) primarily affecting the inter-diverticular colonic mucosa
See this image and copyright information in PMC

References

    1. Diverticular disease associated with inflammatory bowel disease-like colitis: a systematic review. Mulhall AM, Mahid SS, Petras RE, Galandiuk S. Dis Colon Rectum. 2009;52:1072–1079. - PubMed
    1. The endoscopic spectrum of segmental colitis associated with diverticulosis. Tursi A, Elisei W, Brandimarte G, et al. Colorectal Dis. 2010;12:464–470. - PubMed
    1. Diverticular disease-associated segmental colitis. Lamps LW, Knapple WL. Clin Gastroenterol Hepatol. 2007;5:27–31. - PubMed
    1. Segmental colitis associated diverticulosis syndrome. Freeman HJ. World J Gastroenterol. 2016;22:8067–8069. - PMC - PubMed
    1. How to differentiate segmental colitis associated with diverticulosis and inflammatory bowel diseases. Cassieri C, Brandimarte G, Elisei W, et al. J Clin Gastroenterol. 2016;50:0–8. - PubMed

Publication types

LinkOut - more resources