GASTROENTEROLOGY ARTICLE OF THE WEEK
March 15, 2007
Lamps LW, Knapple WL. Diverticular disease-associated segmental colitis. Clin Gastroenterol Hepatol 2007;5:27-31.
1. Histologic features consistent with diverticular colitis include
a. crypt abscesses
b. basal lymphoid aggregates
c. isolated granulomata with giant cells, separate from affected crypts
d. crypt distortion
e. increased inflammation in rectal biopsies
f. Paneth’s cell metaplasia
2. Endoscopic features consistent with diverticular colitis include
a. sparing of the rectum
b. location in the left colon
c. deep furrowing ulcers
d. continuous mucosal involvement, patchy distribution suggests Crohn’s
e. multiple aphthous ulcerations
f. involvement of the right colon near diverticula
True or False
3. Diverticular colitis can be differentiated from ulcerative colitis and Crohn’s disease based on histologic findings
4. Diverticular colitis is not a form of mild diverticulitis
5. When diverticular colitis is suspected, only the erythematous area should be biopsied
6. Inflammation within or around a diverticulum is required in order to suspect the diagnosis of diverticular colitis at endoscopy.
7. The presence of granuloma on colonic biopsies diagnosis Crohn’s disease and excludes diverticular colitis.
8. The initial treatment of diverticular colitis is ASA products and if no response, corticosteroids
9. Some patients with diverticular colitis may progress to classical ulcerative colitis
10. The pathologist can establish the diagnosis of diverticular colitis based on histologic findings without endoscopic correlation