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Clinical and Radiographic Characteristics in Segmental Colitis Associated With Diverticulosis, Diverticulitis, and Crohn's Disease.
Urquhart, Siri A; Ewy, Matthew W; Flicek, Kristina T; Fidler, Jeff L; Sheedy, Shannon P; Harmsen, William S; Chedid, Victor G; Coelho-Prabhu, Nayantara.
Afiliación
  • Urquhart SA; Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
  • Ewy MW; Department of Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
  • Flicek KT; Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
  • Fidler JL; Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
  • Sheedy SP; Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
  • Harmsen WS; Division of Clinical Trials and Biostatistics, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
  • Chedid VG; Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
  • Coelho-Prabhu N; Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Gastro Hep Adv ; 3(7): 901-909, 2024.
Article en En | MEDLINE | ID: mdl-39286621
ABSTRACT
Background and

Aims:

Segmental colitis associated with diverticulosis (SCAD) is an underrecognized disease characterized by chronic segmental inflammation surrounding colonic diverticula. SCAD is recognized as an autonomous entity, although shares similar pathogenic and therapeutic aspects to inflammatory bowel disease and may be considered a complication of diverticulitis. We aimed to characterize the clinical, endoscopic, and radiographic findings of SCAD and its potential overlap with diverticulitis and inflammatory bowel disease.

Methods:

All patients with suspected diagnosis of SCAD were identified using a bioinformatics search tool from January 1996 to October 2021 at our institution. Relevant demographic, clinical, endoscopic, and radiographic data were abstracted. Disease-related outcomes and radiographic characteristics were determined.

Results:

Seventy-five patients with SCAD were included (48.0% female) with average age at diagnosis 62.5 years. Thirty-seven (49.3%) had a prior episode of diverticulitis. The most common presenting symptoms were abdominal pain (33.3%) and hematochezia (22.7%). Antibiotics (42.7%) and mesalamine (36.0%) were most used as first-line treatment options. Twenty (26.7%) required surgical intervention. The most common initial endoscopic finding was isolated sigmoid inflammation (86.7%). Fifty-one patients with confirmed SCAD, 72 with diverticulitis, and 12 with Crohn's disease (CD) had imaging available for review. Penetrating disease was seen in 7 (13.7%) with SCAD compared to 7 (9.7%) and 2 (16.6%) with diverticulitis and CD, respectively (P = .14). Blinded radiologists diagnosed SCAD, CD, or diverticulitis correctly in 43.8%, 8.3%, and 27.1%, respectively.

Conclusion:

SCAD should be considered when isolated sigmoid colon inflammation is seen on cross-sectional imaging. Penetrating disease is not a specific radiologic feature for either SCAD or diverticulitis. Further prospective studies are needed to correlate imaging characteristics with endoscopic findings to better describe radiographic features in SCAD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Gastro Hep Adv Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Gastro Hep Adv Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos