INFLAMMATORY MANIFESTATIONS AT COLONOSCOPY IN PATIENTS WITH COLONIC DIVERTICULAR DISEASE

Antonio Tursi (1) , Walter Elisei (2) , Gianmarco Giorgetti (3) , Fabio Aiello (4) , Giovanni Brandimarte (2)

1 GI Endoscopy, Andria, Italy
2 Department of Internal Medicine, Division of Gastroenterology
3 Clinical Nutrition Unit
4 Department of Quantitative Methods for Human Sciences

Background: Ulcerative colitis with diverticulosis (UCD), segmental colitis associated with diverticulosis (SCAD), and acute uncomplicated diverticulitis (AUD) may affect the same colonic regions, but the real incidence of these entities in clinical practice is unknown. Aim: The aim of our study was to assess the incidence and the endoscopic findings of UCD, SCAD, and AUD. Methods: From January 2004 to June 2009, 8525 consecutive colonoscopies were performed. Diagnosis of the diseases was based on specific endoscopic and histological (UCD and SCAD), and on endoscopic and radiological (AUD) patterns. Results: UCD was diagnosed in 25 patients (0.3%), SCAD was diagnosed in 129 patients (1.5%), and AUD was diagnosed in 130 patients (1.5%). In UCD the inflammation in colonic area harbouring diverticula always affects the overall colonic mucosa in all cases, involving also diverticular orifices The endoscopic characteristic of SCAD is that inflammation is mainly detected within the inter-diverticular mucosa without involvement of the diverticular orifices. In AUD the inflammation affects primarily diverticular orifice and peri-diverticular mucosa. Conclusions: In clinical practice, the incidence of mucosal inflammation in the presence of colonic diverticular disease is low and endoscopy is the mainstay of differential diagnosis.

Mots clés: Medicine

Antonio Tursi, Walter Elisei, Gianmarco Giorgetti, Fabio Aiello, Giovanni Brandimarte. INFLAMMATORY MANIFESTATIONS AT COLONOSCOPY IN PATIENTS WITH COLONIC DIVERTICULAR DISEASE. Alimentary Pharmacology and Therapeutics, 2010, 33 (3), pp.358. ⟨10.1111/j.1365-2036.2010.04530.x⟩. ⟨hal-00599496⟩